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PubMed1980

[A case of intra- and extracranial development of a craniofacial teratoma. Excision during the neonatal period through a mixed cranio-facial approach (author's transl)].

A newborn infant was found to have a laterocervical swelling invading the floor of the mouth. Exploration of the mass revealed that there was invasion of the left side of the soft palate and, more particularly, a prominence in the temporal fossa causing an obvious cranio-facial asymmetry. Radiological and neuroradiological investigations demonstrated the presence of a tumor destroying the greater wing of the sphenoid, invading the left side of the temporal fossa, extending into the pterygomaxillary fossa up to the soft palate, and finally appearing exteriorly in the sub-maxillary region. Excision was carried out in the neonatal period because of the poor tolerance from the neurological point of view. A wide cranio-facial approach was first employed, enabling resection of the point of the temporal lobe, clogging of the cranial base, and excision as one piece of the complete palatocervical extension of the tumor. Follow-up one year later showed that the child possessed excellent neurological development and there was no sign of recurrence of the mass. A review of the published literature showed the extremely rare nature of this type of localization of cervicofacial teratomas (5 other cases have been reported). The surgical procedures and the problems encountered are discussed as well as the indications for excision, based on results obtained in this case and those previously reported. The etiology and anatomy are also reviewed in order to establish their true significance in the case of congenital cranio-facial tumors.

Brain Neoplasms↗
PubMed1993

Face and neck neurogenic neoplasms.

Surgeons should be aware that any mass in the region of the cranial nerves, brachial plexus, cervical sympathetic plexus, or a major peripheral nerve can be of neurogenic origin. Solitary neurogenic tumors of the head and neck can simulate metastatic masses or congenital lesions. If they are resected unrecognized and/or without regard to their nerve origin, major and permanent nerve defects can unnecessarily occur. Thirty-two patients, 16 males and 16 females, ranging in age from 5 to 69 years, had 33 extracranial solitary neurogenic neoplasms resected. The nerves involved were the cervical sympathetic plexus in 7 patients, branchial plexus in 6, spinal accessory nerve in 5, vagus nerve in 4, hypoglossal nerve in 3, facial nerve in 2, and 6 other nerves in 1 patient each. The technique is to dissect out the neurilemoma without destroying the nerve sheath or nerve trunk. Despite careful dissection, the four patients with masses of the vagus nerve had permanent ipsilateral cord paralysis.

Adolescent↗