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Krishna - poster =A CASE STUDY OF TONSILLAR TERATOMA.pptx
1. A CASE STUDY OF
TONSILLAR TERATOMA
DR. KRISHNA MAKADIA DR. SUSIL G. JHA
1st Year Resident Prof. and Head of the Dept.
Mobile No. : 8238024725
Email : makadiakrishna42@gmail.com
Department of Otorhinolaryngology
and Head & Neck Surgery
Sir T hospital, govt. Medical College, Bhavnagar.
2. INTRODUCTION
• The teratoma is a germ cell neoplasms composed of endoderm ,
mesoderm , ectoderm.
• They could rarely produce and have different clinical picture,
depending upon different germinal cells.
• The teratomas are commonly seen in neonatal period or after first
decade of life.
• They are associated with high level of mortality, especially because of
respiratory distress.
• They are commonly benign and asymtomatic arising most commonly
from sex organs, ovaries and testes.
3. • The sacrococcygeal teratoma is most common extragonadal origin.
• Other localization : head area,orbital,nasopharynx, thyroid, cervical
and mediastinal.
• The nasopharyngeal teratoma causes aerodigestivetract obstruction.
• The first case reported in Thailand in neaonatal female having
immature teratoma of nasopharynx extending to soft palate and right
side tonsillar fossa.
5. SIGNS AND SYMPTOMS
• People with teratoma may not show any symptoms at first.
• But causes symptoms like:Thorat pain,Difficulty in
swallowing,earachae,
6. CASE STUDY
• A case of 13 year old male patient residing at Bhavnagar.
• Patient presented with a complaint of throat pain and difficulty in swallowing since 4 months.
• Associated occasionally with vomiting, common cold , coughing and right ear discharge.
• ON EXAMINATION :
• ORAL CAVITY : Approximately 4*4 cm single nonwarm, nontender, soft , smooth , freely mobile
globular mass palpable over right side tonsillar fossa.
• EAR : Right : Small central perforation Left : Intact / Normal drum
• NOSE : No any abnormality found
7. INVESTIGATION
• Patient underwent CECT NECK : S/O Possibility of
OROPHARYNGEAL TERATOMA arising from right sided tonsillar
fossa.
• Patient was planned to be operated under general anaesthesia so all
routine investigations was done.
8. OPERTATIVE PROCEDURE
• Patient was given tonsillar position.
• The tonsillar teratoma was removed with coldstealed method.
• The excised teratoma was sent for frozen section and histopathological
study.
9. POST OPERATIVE
• Frozen section is suggestive of benign lesion most likely teratoma with
predominant lipomatous components with all margins free.
• Histopathological report: Gross and Microscopic appearence
suggestive of specimen containing white solid area with teeth like
structures in between dense fibrous tissue with normal minor salivary
tissue. Impression : Benign soft tissue lesion with ossifying fibro-
lipoma S/O Oropharyngeal immature type of Teratoma
10. CONCLUSION
• The extra cranial head and neck teratoma are rarely affected
accounting for less than 5% of all reported cases.
• The teratoma of nasopharynx/oropharynx typically induces obstruction
of the proximal oro-respiratory tract, which requires rapid airway
management and often associated with distinct deformities of the
cranial and facial structures.
• The authors remind that immature or mature part of teratomatous
tumor is not that much important factor in head neck region but size of
a teratoma is the major problem leading to mechanical airway
obstructiсn and secondary infection.[3],[6]
11. REFERENCES
• 1. KH. Neonatalneoplasia. In AGM Campbell, Neil, eds.MCINTOSHForfar and Arneil's Text Book
oflivingstone. 1998: 290-291.2.
• 2. Lavis CF, Carachi R, Young DG Neonatal Tumour: Glasgow Ar DisChildi ood 1955–1986; 63:
1075 1078
• 3. Chuaan-Tiech Chew Nasopharynx (the post nasal space). In Alan G. Kerred. Scott-Brown's
Otolaryngology, 6th ed. Oxford, Ox2 8DP; Butterworthheinemann, 1997:5, 13, 25.
• 4. Cotran, Kumar, Robbins. Rubbins Pathologic Basis of disease, 5th ed. Aprism indian edition,
Bangalore. 16. W.B. Saunders Company. 1994; 457458.******
• 5.Ferronob Ballenger, James B. SnowOtorhinolaryngology, Head & NeckSurgery, 15th ed. A Lea
& Febinger Book Williams & Wilkins; 1996; 216.
• 6.Ferron JA, Munro IR, Bruce DA, Whitaker LA. AI: Massiveeratomainvolving the cranial base.
Treatmentand outcome: a two center report.Plast Reconst Surg 1993; 91: 223.
• 7. Kozart PR, iwane A, Kulkarni B; Congenital nasopharyngealteratomawith cleft palate. Indian
Assoc Pediat Surg 2004; 9: 42-45.