Rare congenital tumor as an atypical cause of neonatal stridor: Case report of a rare case of neonatal stridor and atypical evolution of late airway obstruction due to congenital oropharyngeal teratoma (Epignathus)

Abstract

BACKGROUND: Epignathus is the term used for congenital oropharyngeal teratoma, a rare condition however with great potential to cause fetal airway obstruction, attending with respiratory insufficiency and being able to cause perinatal death. Usual imaging exam in pregnancy follow-up such as ultrasonography can detect mass-type lesions occupying the head and neck region of the fetus, also commonly associated with polydramnium. The early diagnosis of Epignathus assists in planning management as delivery and adequate procedures to guarantee the fetal airway. CASE: We report an atypical case of a 44-day-old baby girl, born without complications, but with parents reports of mild stridor from birth without investigation, progressed with severe respiratory insufficiency requiring orotracheal intubation in emergency service. At the time, a mass was detected on oropharynx obstructing airway. After the surgical exeresis of the mass, histopathological study revealed mature teratoma. CONCLUSION: Neonatal stridor, however mild, requires an adequate investigation of the probable etiology. In medical practice, cases of severe stridor associated with symptoms such as respiratory effort or difficulty feeding tend to be more valued. Epignathus is not a common cause of neonatal stridor, especially in cases of late manifestations.