Teratoma of the nasopharynx in a 46-day-old boy leading to airway obstruction - a case report and literature review

Sep 30, 2026

Nasopharyngeal teratomas are rare extragonadal germ cell tumors in the head and neck that may obstruct the airway, creating major neonatal clinical risk. The report describes a 46-day-old boy with respiratory distress from a mature teratoma in the right nasopharyngeal region. After early respiratory management and diagnostic evaluation including bronchoscopy and imaging, the patient underwent surgical debulking using a modified Loeb palatal incision by a multidisciplinary team. Histopathology confirmed a mature teratoma, and postoperative care emphasized intensive monitoring and metabolic management. The case highlights early diagnosis, prompt collaborative intervention, and surgical excision with ongoing monitoring to prevent life-threatening complications.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

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Introduction

Case Report

Archives of Craniofacial Surgery Arch Craniofac Surg Vol.26 No.6, 255-260 [https://doi.org/10.7181/acfs.2025.0042](https://doi.org/10.7181/acfs.2025.0042) Teratoma of the nasopharynx in a 46-day-old boy leading to airway obstruction: a case report and literature review Balaji Jayaraman, Triveni Palani, Davidson Rajiah, Sahana Bhaskar Holla, Shanmugapriyan Durairaj, Harish Suresh Kulkarni Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai, India Nasopharyngeal teratomas are rare extragonadal germ cell tumors that occur infrequently in the head and neck region, with an incidence of 1 in 40,000 live births. These tumors, often detected at birth or in early infancy, consist of various tissues derived from multiple germ cell layers and can pose significant clinical challenges due to their propensity to obstruct the airway. We report a case of a 46-day-old boy who presented with respiratory distress due to a mature teratoma located in the right nasopharyngeal region. Following initial respiratory management and diagnostic workup, which included bronchoscopy and imaging, the patient underwent surgical debulking using a modification of the Loeb palatal incision by a multidisciplinary team to alleviate airway obstruction. Histopathology confirmed a mature teratoma, and postoperative care included intensive monitoring and metabolic management. This case underscores the critical need for early diagnosis, prompt intervention, and collaborative management to prevent life-threatening complications in neonates with nasopharyngeal teratomas. Surgical excision remains the primary treatment for these cases, with postoperative monitoring essential for ensuring patient stability. This case contributes to the literature on neonatal nasopharyngeal teratomas, emphasizing the role of a multidisciplinary approach in achieving favorable outcomes in complex presentations of this rare condition. Abbreviations: AFP, alpha-fetoprotein; β-hCG, β-human chorionic gonadotropin; EGCT, extragonadal germ cell tumor; GCT, germ cell tumor; MRI, magnetic resonance imaging; SIMV-PC+PS, synchronized intermittent mandatory ventilation–pressure control with pressure support Keywords: Airway obstruction / Case reports / Infant / Maxillofacial surgical procedures / Nasopharyngeal neoplasms / Teratoma INTRODUCTION A teratoma is defined by Willis as a true neoplasm composed of multiple tissues foreign to the part in which it arises [1]. Teratomas are one of the common extragonadal germ cell tumors (EGCTs) of childhood, consisting of tissues from at least two of Correspondence: Triveni Palani Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, NO.1, TNPSC Salai, Chennai 600003, India [E-mail: drtrivenimds@gmail.com](E-mail: drtrivenimds@gmail.com) How to cite this article: Jayaraman B, Palani T, Rajiah D, Holla SB, Durairaj S, Kulkarni HS. Teratoma of the nasopharynx in a 46-day-old boy leading to airway obstruction: a case report and literature review. Arch Craniofac Surg 2025;26(6):255-260. [https://doi.org/10.7181/](https://doi.org/10.7181/)[ ](https://doi.org/10.7181/)acfs.2025.0042 Received August 17, 2025 / Revised September 23, 2025 / Accepted December 8, 2025 the three germ cell layers [2]. The clinical manifestation depends on the size and site of the lesion. The lesions presenting in the aerodigestive tract result in nasal blockage, difficulty in breathing, breastfeeding, rhinorrhea and snoring. It can also present with occasional bouts of respiratory distress and cyanosis [3]. The teratomas of the head and neck region might pose difficulty in surgical management. We present a case report ofa 46-day-old boy with a nasopharyngeal mass that was histologically defined as a mature teratoma, and summarize a review of the literature on teratomas of the nasopharynx. CASE REPORT A 46-day-old boy was referred to the Department of Oral and © 20

FAQs

What problem did the patient present with, and where was the teratoma located?

The 46-day-old boy presented with respiratory distress. Bronchoscopic and imaging evaluation identified a mature teratoma located in the right nasopharyngeal region.

What diagnostic workup was performed before surgery?

The workup included initial respiratory management followed by diagnostic evaluation with bronchoscopy and imaging, including magnetic resonance imaging and other relevant assessments.

How was airway obstruction managed surgically and postoperatively?

After stabilization, the team performed surgical debulking using a modification of the Loeb palatal incision. Postoperative care included intensive monitoring and metabolic management to ensure patient stability.

Sep 30, 2026

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