PMC9446077_01
(A, B) Sonogram of the fetus with a posterior neck tumor at 23 weeks of gestation. (A) sagittal section; (B) color Doppler flow imaging; (C, D) Magnetic resonance multiple sequence imaging of the fetal neck tumor at 23 weeks of gestation. (C) sag T2SSFSE; (D): Ax DWI b = 600.
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Two-dimensional ultrasonography revealed a solid, heterogeneous echogenic exophytic mass of approximately 4.2 x 3.7 x 4.0 cm that was well demarcated from the spine, and the leading edge was close to the skin ( Figure 1A ). Figure 1B ). Fetal magnetic resonance imaging, performed the following day, confirmed the presence of this tumor with high-low mixed signals and a clear boundary on T2-weighted imaging. In addition, no airway extension or obstruction was observed ( Figures 1C, D ). When the RF energy was set to 50 W, the ablation sphere diameter was approximately 1.5 cm after 3 min ( Figure S1A ), and when the RF energy was 100 W, the diameter was approximately 2.5-3.0 cm in the same period ( Figure S1B ).
(A, B): Percutaneous intrauterine biopsy at 29+ weeks of gestation. (A) Operation pattern diagram; (B) Percutaneous intrauterine biopsy under ultrasound guidance during operation. (C, D): RF ablation therapy at 29+ weeks of gestation. (C) Operation pattern diagram; (D) RF ablation therapy under ultrasound guidance during operation.
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Two tumor tissue biopsy samples were fixed with formalin and sent for pathological examination ( Figures 2A, B ). RF ablation was performed immediately after biopsy by inserting the RF electrode in the center of the tumor, 1.5-2.0 cm away from the edge of the tumor tissue ( Figures 2C, D ). The fetal posterior neck solid tumor was identified as a congenital hemangioma (CH) through subsequent biopsy and histopathology ( Figure S2 ).
Fetal and neck tumor growth curves. "... in red" indicates the time that the fetus received intrauterine treatment. (A) The red curve: biparietal diameter; brown curve: fetal length; blue curve: tumor volume; (B) red curve: biparietal diameter; brown curve: fetal length; blue curve: maximum tumor diameter; black curve: mean tumor diameter; purple curve: tumor thickness.
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The thickness of the tumor was measured in the sagittal section of the fetus, which was significantly decreased, whereas the reductions in the maximum and mean tumor diameters were not as obvious as that in the thickness ( Figure 3B ).
(A, B): Doppler ultrasonography was used to observe the blood flow signal of the fetal posterior neck tumor after surgery. (A) One week after surgery; (B) One month after surgery. (C): A solid and soft mass of approximately 6 x 5 x 4 cm protruded from the posterior neck of the newborn. (D): A solid and soft mass of approximately 5 x 3 x 3 cm protruded from the posterior neck of the 42-day-old infant.
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Pigmentation of approximately 1.0 x 1.0 cm was visible at the puncture point, and no obvious scars or burn marks were observed ( Figure 4C ). In the 42-day-old infant, the posterior neck mass had shrunk (5 x 3 x 3 cm) and the skin on the package surface was very loose ( Figure 4D ).
PMC9446077_02
(A, B): Doppler ultrasonography was used to observe the blood flow signal of the fetal posterior neck tumor after surgery. (A) One week after surgery; (B) One month after surgery. (C): A solid and soft mass of approximately 6 x 5 x 4 cm protruded from the posterior neck of the newborn. (D): A solid and soft mass of approximately 5 x 3 x 3 cm protruded from the posterior neck of the 42-day-old infant.
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Pigmentation of approximately 1.0 x 1.0 cm was visible at the puncture point, and no obvious scars or burn marks were observed ( Figure 4C ). In the 42-day-old infant, the posterior neck mass had shrunk (5 x 3 x 3 cm) and the skin on the package surface was very loose ( Figure 4D ).