PMC4700629_01
Intraoperative view of the pharynx prior to laser resection. When examining the surgical site, a protruding pediculated mass covered by mucous membranes (indicated by arrow) is clearly visible below the uvula. The endotracheal tube is still in position at that time, but cannot be readily seen due to a space-occupying effect of the tumor
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Fig1
On the sixth day of life, flexible endoscopy was performed and revealed a mucous protrusion of the dorsal oropharynx (Fig. 1).
Magnetic resonance imaging of the head and neck region. Sagittal magnetic resonance image (T1-TSE) after contrast showing a pediculated 6.6 x 17.4 x 10 mm muscle-isointense lesion with a moderate uptake of contrast agent at the level of the second and third cervical vertebrae
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Fig2
On the seventh day of life, the patient was electively intubated and underwent magnetic resonance imaging, which showed a pediculated soft-tissue-isointense lesion of approximately 6.6 x 17.4 x 10 mm located at the dorsal oropharynx (Fig. 2).
Intraoperative view of the pharynx after laser resection. The pediculated tumor has been successfully removed by laser resection. Minimal residual bleeding can be noted on the left ventrolateral resection margin (indicated by arrow)
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Fig3
The following day, this lesion was removed transorally by potassium titanyl phosphate (KTP) laser resection and processed for histological evaluation (Fig. 3).
Surgical specimen. A double-branched tumor covered by mucous membranes measuring approximately 28 x 21 x 16 mm is removed by laser resection. Residual bleeding and thermic damage can be noted on the surface
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Fig4
Macropathology was consistent with a mature teratoma (Fig. 4).
Histopathology. Histopathological examination identified several cystic structures lined with either squamous or columnar epithelium, gastric type, surrounded by fibroconnective and muscular stroma (a, b). In addition foci of lymphatic tissue (c) and small mucinous glands admixed with hyaline cartilage (d) were seen. Findings were consistent with a mature teratoma. Signs of malignancy were absent
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Fig5
This diagnosis was subsequently confirmed by histopathology (Fig. 5).