Halfway through pregnancy, Katy Preidt and Dustin Lower received the news that their baby had a tumour growing on his neck. Immediate concerns were raised, as doctors feared that, once delivered, the tumour would block the infant's airway.

De Lucia, N. Prescription Health: Cancer scare in the womb. KRGV Channel 5 News. May 1, 2025.

Their baby's high-risk birth required a specialised delivery called an EXIT procedure, which allowed the infant to be intubated while still receiving oxygen from the placenta. Fortunately, tests later revealed that the tumour, a cervical teratoma, was cancer-free.

More about cervical teratomas

Cervical teratomas are rare congenital tumours that develop in the neck region, predominantly in neonates. These tumours are of germ cell origin and can present significant challenges due to their size and potential to obstruct vital structures.

Abdennadher, M., Ben Amara, K., Abdelkebir, A. et al. Cervical Benign Teratoma: Case Report and Review of Literature. Indian J Otolaryngol Head Neck Surg 75, 2409–2413 (2023). https://doi.org/10.1007/s12070-023-03748-8

A cervical teratoma is a mass composed of tissues from all three embryonic germ layers: ectoderm, mesoderm, and endoderm.

Cervical Teratoma. National Organisation for Rare Disorders. October 25, 2017.

These tumours are classified as extragonadal germ cell tumours, meaning they occur outside the gonads. While most cervical teratomas are benign, they can cause severe complications due to their location and size.​

Cervical Teratoma. National Organisation for Rare Disorders. October 25, 2017.

Clinical presentation and diagnosis

Cervical teratomas are often detected prenatally during routine ultrasounds, typically around 18 weeks of gestation.

Postnatal presentation includes respiratory distress, feeding difficulties, and visible neck masses. Diagnosis is confirmed through imaging studies such as ultrasound and MRI, which help delineate the extent of the tumour and its relationship to surrounding structures.

Wattimury S, Violetta L. Cervical mature teratoma in pediatric. Radiol Case Rep. 2022 Sep 30;17(12):4675-4678. doi: 10.1016/j.radcr.2022.08.106. PMID: 36204400; PMCID: PMC9530406.

Treatment and management

The primary treatment for cervical teratomas is surgical resection. Given the potential for airway obstruction, delivery planning is crucial.

In cases where airway management is anticipated to be challenging, an Ex Utero Intrapartum Treatment (EXIT) procedure may be performed. This approach allows for controlled airway management and immediate surgical intervention after birth.

Olivares, E., Castellow, J., Khan, J., Grasso, S., & Fong, V. (2018). Massive fetal cervical teratoma managed with the ex utero intrapartum treatment (exit) procedure. Radiology Case Reports, 13(2), 389-391. https://doi.org/10.1016/j.radcr.2017.12.011

Postoperative care includes monitoring for complications such as hypothyroidism, hyperparathyroidism, and developmental delays. Long-term follow-up is essential to assess for recurrence or malignant transformation, particularly in cases with incomplete resection.

Malhotra S, Negi P, Sagar P. A Case of Cervical Teratoma in an Infant. Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):6519-6523. doi: 10.1007/s12070-021-02942-w. Epub 2021 Oct 20. PMID: 36742920; PMCID: PMC9895199.

Risk factors and prognosis

The exact aetiology of cervical teratomas remains unknown; however, they are not considered hereditary and do not typically recur in subsequent pregnancies.

Cervical teratomas, while rare, present significant challenges in neonatal care. Early detection through routine prenatal screening and a multidisciplinary approach to delivery and postoperative care are essential for optimal outcomes.