Prenatal course and diagnostics
A 28-year-old III G I P gravida in the 28th week of
pregnancy was referred to our prenatal diagnostic center due to the
suspicion of a fetal neck tumor detected by prenatal ultrasound. The
course of pregnancy was uneventful until the 28th week
of pregnancy. The mother reported one prior spontaneous abortion and had
no regular medication. The parents were of Caucasian origin and
nonconsanguineous and the family history was otherwise unremarkable.
A detailed fetal anatomic ultrasound survey confirmed a fetal neck tumor
with a dimension of 45 x 46 x 39 mm located at the anterior neck,
presenting morphological features of a cystic-caverneous
lymphhemangioma. The tumor extended from the right submandibular region
across the front of the neck to the opposite side, with weak
vascularization. The tumor was supposed to infiltrate the base of the
mouth. Additionally, the mass could not be separated from the upper
thoracic aperture (Fig. 1 a, b). With the exception of a polyhydramnios,
no further sonomorphological abnormalitiy of the fetus was detected. The
fetus showed an appropriate growth with an estimated fetal weight of
1,020 g corresponded to the 28th percentile. The
parents decided against an amniocentesis. Subsequent ultrasound
examinations within two to three months showed the growth of the tumor
(73 x 68 x 41 mm), which was already strongly vascularized and now
affecting the floor of mouth, but without identifying its entity beyond
any doubt (Fig. 1 c, d). The parents were interdisciplinary counselled
together with neonatologists and pediatric surgeons. Magnetic resonance
imaging (MRI) was performed, confirming the inhomogeneity as well as the
extent of the tumor but were also unable to clarify the definite tumor
entity.