Journal of Maxillofacial and Oral Surgery

, Volume 10, Issue 3, pp 253–256 | Cite as

Congenital Nasopharyngeal Teratoma with a Cleft Palate: Case Report and a 7 Year Follow Up

  • Dinesh Singh Chauhan
  • Yadavalli GuruprasadEmail author
  • Singhvi Inderchand
Cyst and Tumor


Teratomas are benign tumors containing cells from ectodermal, mesodermal and endodermal layers. They occur in about 1 in every 4,000 births and most commonly in the sacrococcygeal region, followed by the ovaries. Congenital epignathus teratomas are rare embryological neoplasms localised in the region of head and neck. An epignathus is found in approximately 1:35,000–1:200,000 live births. This accounts for 2–9% of all teratomas. Size and location of the neoplasm in the oronasopharynx is variable. Teratomas are partly undiagnosed at the time of birth. They may exist with an intracranial extension or as small polyps. Large epignathi can lead to difficult management during and after birth. We present a case of a female infant with a combination of nasopharyngeal teratoma and a cleft palate with successful multidisciplinary management via a staged surgical approach. The epignathus presented as a huge mass extending out of the mouth of the infant girl. On the day of birth debulking of the extraoral portion of the tumor, followed by intraoral extirpation and cleft palate repair at a later stage, was performed. The results of the histopathological examination confirmed diagnosis of a congenital teratoma.


Epignathus Nasopharyngeal teratoma Cleft palate 


Conflict of Interest



  1. 1.
    Noguchi T, Jinbu Y, Itoh H, Matsumoto K, Sakai O, Kusama M (2006) Epignathus combined with cleft palate, lobulated tongue, and lingual hamartoma: report of a case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101(4):481–486PubMedCrossRefGoogle Scholar
  2. 2.
    Ehrich WE (1945) Teratoid parasites of the mouth (episphenoids, epipalati, epignahi). Am J Orthodont Oral Surg 31:650–659CrossRefGoogle Scholar
  3. 3.
    El-Musa KA, Shehadi RS, Shehadi S (2006) Surgical repair of unidirectional palatopharyngeal epignathus: case report and review of literature. Cleft Palate Craniofac J 43(3):367–369PubMedCrossRefGoogle Scholar
  4. 4.
    Ochsner A, Ayers WB (1951) Case of epignathus: survival of host after its excision. Surgery 30:560–564PubMedGoogle Scholar
  5. 5.
    Takato T, Nakatsuka T, Ohhara Y (1985) Teratoid in the oral cavity. Ann Plast Surg 14(5):451–453PubMedCrossRefGoogle Scholar
  6. 6.
    Kaplan C, Permutter S, Molinoff S (1980) Epignathus with placental hydrops. Arch Pathol Lab Med 104(7):374–375PubMedGoogle Scholar
  7. 7.
    Clement K, Chamerlian R, Boyd P, Molyneux A (2001) Prenatal diagnosis of an epignathus: a case report and review of the literature. Ultrasound Obstet Gynecol 18(2):178–181PubMedCrossRefGoogle Scholar
  8. 8.
    Pothari PR, Jiwan A, Kulkarni B (2004) Congenital nasopharyngeal teratoma with cleft palate. J Indian Assoc Pediatr Surg 9:42–45Google Scholar
  9. 9.
    Ewing J (1940) Neoplastic Diseases, 4th edn. WB Saunders, PhiladelphiaGoogle Scholar
  10. 10.
    Yang ST, Leow SW (1992) Intracranial fetus in fetu: CT diagnosis. AJNR Am J Neuroradiol 13:1326–1329PubMedGoogle Scholar
  11. 11.
    Johnston JM, Vyas NA, Kane AA, Molter DW, Smyth MD (2007) Giant intracranial teratoma with epignathus in a neonate. Case report and review of the literature. J Neurosurg 106(3 Suppl):232–236PubMedGoogle Scholar
  12. 12.
    Rintalu A, Ranta R (1974) Separate epignathi of the mandible and nasopharynx with cleft palate: case report. Br J Plast Surg 27(1):103–106CrossRefGoogle Scholar
  13. 13.
    Gifford GH Jr, MacCollum DW (1972) Facial teratoma in the newborn. Plast Reconstr Surg 49(6):616–621PubMedCrossRefGoogle Scholar
  14. 14.
    Gundry SR, Wesley JR, Klein MD, Baar M, Coran AG (1983) Cervical teratomas in the newborn. J Pediatr Surg 18(4):382–386PubMedCrossRefGoogle Scholar
  15. 15.
    Hassan S, Sidek DS, Shah Jihan WD, Phutane G, Mutum SS (2007) Massive lingual teratoma in a neonate. Singapore Med J 48(8):e212–e214PubMedGoogle Scholar
  16. 16.
    Makki FM, Al-Mazrou KA (2008) Nasopharyngeal teratoma associated with cleft palate in a newborn. Eur Arch Otorhinolaryngol 265(11):1413–1415PubMedCrossRefGoogle Scholar
  17. 17.
    Benson RE, Fabbroni G, Russell JL (2009) A large teratoma of the hard palate: a case report. Br J Oral Maxillofac Surg 47(1):46–49PubMedCrossRefGoogle Scholar

Copyright information

© Association of Oral and Maxillofacial Surgeons of India 2011

Authors and Affiliations

  • Dinesh Singh Chauhan
    • 1
  • Yadavalli Guruprasad
    • 1
    Email author
  • Singhvi Inderchand
    • 2
  1. 1.Department of Oral & Maxillofacial SurgeryAME’S Dental College Hospital & Research CentreRaichurIndia
  2. 2.Raichur Institute of Medical SciencesRaichurIndia

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