A case report and literature review on imaging manifestations of immature teratoma in fetal oral cavity with concurrent intracranial abnormalities.

OBJECTIVE

To explore the imaging characteristics of immature teratoma in fetal oral cavity and enhance the diagnostic and differential diagnostic ability for this condition.

METHODS

The clinical, pathological, and imaging features of a case of immature teratoma occurring in a fetus were analyzed. A systematic literature review was conducted, and prior cases were summarized in a comparative table to identify patterns and knowledge gaps.

RESULTS

Imaging manifestations of fetal oral cavity immature teratoma included: (1) A large solid-cystic mass protruding from the fetal oropharynx, closely related to the maxilla and skull base; (2) CT revealed heterogeneous density within the tumor, with a predominantly cystic appearance and punctate calcifications within the solid component-a feature more commonly associated with immature teratomas; (3) MRI demonstrated an irregular solid-cystic mass in the lesion's oropharyngeal region, with low signal intensity on T1WI, internal areas of mixed signal intensity, high signal intensity on T2WI, and restricted diffusion (high DWI signal) within the solid components, corresponding to immature neuroepithelial elements on histopathology. Pathological examination confirmed a Grade III immature teratoma with concurrent right temporal arachnoid cyst and meningocele.

CONCLUSION

Immature teratoma occurring in the fetal oral cavity is a rare condition. Multimodal imaging with systematic description of tumor location, composition, calcification, and mass effect enables accurate prenatal diagnosis and differentiation from other oral masses. Concurrent intracranial abnormalities, though uncommon, warrant thorough evaluation. Understanding its clinical and imaging features can improve the level of diagnostic proficiency for this disease.