Large congenital cervical teratoma in a neonate: EXIT procedure under spinal anesthesia and early surgical excision -A case report.

BACKGROUND

Cervical teratomas are rare congenital tumors in neonates associated with high morbidity and mortality due to the potential for severe airway obstruction at birth. Here, we present a case of successful airway management using an ex utero intrapartum treatment (EXIT) procedure under spinal anesthesia for a prenatally detected cervical mass, with definitive treatment achieved by postnatal surgical excision.

CASE: The infant was born via emergency cesarean section after exhibiting fetal distress due to a cervical mass and underwent an EXIT procedure under spinal anesthesia. A surgical tracheostomy was performed as the newborn could not be intubated. On postnatal day 6, a 439-g cervical teratoma was successfully removed, and the patient was discharged on postnatal day 48.

CONCLUSIONS

This case suggests that spinal anesthesia may represent a viable anesthetic option for EXIT procedures in neonates with cervical teratoma in selected emergency settings while maintaining uteroplacental circulation and enabling rapid airway control.