Congenital cervico-mediastinal masses: Difficulties of prenatal diagnosis and neonatal management. Two case reports

Congenital cervico-mediastinal masses are a rare and severe pathology that can be life threatening at birth. There are many histological types but the most common are teratoma and cystic lymphangioma. The morbidity and the mortality of these tumors are related to the size of the tumor that may cause tracheal and oesophageal distortion and obstruction. Without prenatal diagnosis, a giant neck mass can be fatal for the neonate. Death is usually associated with a delay in obtaining an airway and an inability to ventilate the neonate. An adequate management must be planned by a multidisciplinary team, early elective cesarian delivery and a deferred clamping of the umbilical cord until the airway is secured and then a surgical treatment of the tumor. It is the best way to lessen the neonatal morbidity and mortality related to these tumors. We describe the difficulties of diagnosis and management of this pathology through two cases and a review of the literature. (C) 2010 Elsevier Masson SAS. All rights reserved.