Fetal oropharyngeal and neck tumors: Determination of the need for ex-utero intrapartum treatment procedure

Abstract

Background: The aim of this study was to assess theex-utero intrapartum therapy (EXIT) applied to 3 of the7 cases with oropharyngeal or neck masses and reviewthe indicators of the need for an EXIT procedure.Case Report: Prenatal presentation, size and local-ization of the masses, existence of fetal hydrops andassociated findings such as polyhydramnios, intraop-erative managements, complications, and maternal andneonatal outcomes were evaluated through a retrospec-tive analysis. Four cases had neck masses and threecases had oropharyngeal masses. Prenatal sonographywas used as the main diagnostic tool for all patients.The median gestational age was 34.5 weeks at the timeof diagnosis and 36 weeks at delivery. Polyhydramni-os was observed in three of the seven cases and theywere delivered prematurely. Interventions such as en- dotracheal intubation or tracheostomy were performedto provide patency of the airway during delivery bythe EXIT procedure in three cases. Hemangioma wasfound in two cases, teratoma in two cases, lymphangi-oma in two cases and hamartoma in one case followingpathological examination of the masses.Conclusion: The localization of mass, its characteris-tics, invasion (if it exists), and relation to the airway arethe main factors used to determine the need for EXIT.The presence of polyhydramnios may be an importantindicator to predict both the need for EXIT and fetaloutcomes.