Purpose or Case Report: The purpose of this exhibit is to depict the prenatal imaging features of isolated intra-oral lesions, describe delivery course, and correlate with final diagnoses.
Methods & Materials: This retrospective study was submitted for IRB approval. Using departmental search software, prenatal cases of intra-oral lesions were identified. Gestational age at evaluation and delivery, gender, the prenatal imaging appearance by US and MRI, surgical interventions and outcomes were reviewed.
Results: The diagnoses included granular cell tumor, foregut duplication cyst, lymphatic malformation, pharyngeal cyst and orofacial teratoma. Amniotic fluid in all pregnancies was within the normal range. Normal fetal airway contours and a normal stomach were visible in all cases.
- Both granular cell tumors had characteristic imaging features: homogeneously low signal on T2W images, similar to fetal muscle, and moderately bright on T1W sequences. Both granular cell tumors increased in size prior to delivery, and were noted to be vascular at delivery. Otolaryngologists were present at both deliveries. One patient at delivery was found to have multiple granular cell tumors and was in laryngospasm.
- The MRI and US appearance of the pharyngeal cyst and the foregut duplication cyst was that of simple-appearing, isolated, well defined fluid structures. Both deliveries were uncomplicated.
- The lymphatic malformation of the cheek had a characteristic infiltrative imaging appearance and delivery was uneventful.
- The pregnancy with a presumed facial teratoma (epignathus) was terminated.
Conclusions: Fetal oral lesions are uncommon, usually benign, and frequently have unique imaging characteristics allowing for a confident diagnosis. In spite of this, careful delivery planning is advised in all cases with an intra-oral lesion to anticipate advanced airway management. In particular, the 2 cases of granular cell tumors in our series demonstrated an increase in size between diagnosis and delivery, and otolaryngology expertise was utilized for both deliveries.