Purpose or Case Report: The purpose of this case report is to describe a rare case of epignathus (oral teratoma) with lateral skull base and intracranial extension. A 29-year-old G4P1122 female was referred to our institutuion after third trimester ultrasound and fetal MRI revealed a 34 week fetus with oral mass. There was extension intracranially through the lateral skull base. The complex mass showed cystic, solid, and fatty components. Polyhydramnios was also demonstrated. The prenatal imaging was crucial in planning the delivery of the fetus using EXIT procedure. Postnatal MRI Head and Neck, CT Head and Neck, CTA Head and Neck were helpful in guiding surgical resection of the oral, skull base, and intracranial mass. Emphasis will be made on the value of imaging to guide the management of this extremely difficult and rare case.
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