A clinical case of management of a newborn with anterior mediastinal teratoma (not prenatally detected) in a city maternity hospital

Authors

  • A.O. Pysariev Shupyk National Medical Academy of Postgraduate Education, Ukraine
  • N.P. Honcharuk Kyiv City Maternity Hospital No. 1, Ukraine
  • I.I. Hatsko Kyiv City Maternity Hospital No. 7, Ukraine
  • N.L. Savostikova National Children’s Specialised Hospital «OHMATDYT» Ministry of Health of Ukraine, Ukraine

DOI:

https://doi.org/10.15574/PP.2020.83.81

Keywords:

newborn, mediastinal teratoma, diagnostics, therapy

Abstract

Teratomas are tumors which are composed of tissues derived of more than one germ cell layer; they appear between 3-6 weeks of pregnancy and are present more often in females. A prognosis for life depends on the timely diagnosis of the mass and a possibility of surgical treatment.

An article presents a case of a female neonate born with severe respiratory insufficiency. Antenatal ultrasound at 19-20 and 30-31 weeks exposed the myoma of the uterus and a probability of large birth weight. Immediately after birth a neonate requested urgent intubation, artificial lung ventilation, intensive therapy for hemodynamic stabilization. The thoracic surgeon suspected the presence of cystic adenomatous malformation upon the chest X-ray and clinical observation data and defined expectant management and prolongation of intensive therapy. Autoptical evidence is a large mediastinal teratoma 10×8×5 cm, weight 135.0 gram, moderate secondary hypoplasia of lungs. Histological processing revealed mass lesion of the anterior mediastinum in a capsule, which was presented with immature discohesive mesenchyme with lymphoid assembly, brain tissue and multiple cysts of different size with inclusions of cartilage tissue. Effective correct and precise antenatal visualization, which can defined the type of maternity hospital, postnatal MRT and timely provided therapy intervention surgical mass removal including — these are key factors of successful management newborns suffering from anterior mediastinal teratomas.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies.

References

Anheyer D, Frawley J, Koch AK, Lauche R, Langhorst J, Dobos G, Cramer H. (2017). Herbal Medicines for Gastrointestinal Disorders in Children and Adolescents: A Systematic Review. PEDIATRICS: 139 (6): e20170062. https://doi.org/10.1542/peds.2017-0062; PMid:28562281

Benninga MA, Nurko S, Faure C et al. (2016). Childhood functional gastrointestinal disorders: neonate/toddler. Gastroenterology. 150 (2): 1443-1455. https://doi.org/10.1053/j.gastro.2016.02.016; PMid:27144631

Camilleri M, Park S-Y, Scarpato E, Staiano A. (2017, February). Exploring Hypotheses and Rationale for Causes of Infantile Colic. Neurogastroenterol Motil. 29 (2): 10. https://doi.org/10.1111/nmo.12943; PMid:27647578 PMCid:PMC5276723

Canani RB, Terrin G, Rapacciuolo L, Miele E, Siani MC, Troncone R et al. (2008). Faecal calprotectin as reliable non-invasive marker to assess the severity of mucosal inflammation in children with inflammatory bowel disease. Digestive And Liver Disease. 40 (7): 547-553. https://doi.org/10.1016/j.dld.2008.01.017; PMid:18358796

Chien-Heng Lin, Hsiu-Chuan Yang, Chien-Sheng Cheng, Chin-En Yen et al. (2015). Effects of infant massage on jaundiced neonates undergoing phototherapy. Italian J Pediatr. 41 (94): 2-6. https://doi.org/10.1186/s13052-015-0202-y; PMid:26607061 PMCid:PMC4659198

Harb Tracy, Matsuyama Misa, David Michael et al. (2016). Infant Colic What works: A Systematic Review of Interventions for Breast-fed Infants. Journal of Pediatric Gastroenterology and Nutrition. 62 (5): 668-686. https://doi.org/10.1097/MPG.0000000000001075; PMid:26655941

Hassan Salehipoor, Behzad Afzali, Rahim Akrami, Fereshteh Ghorat, Zahra Niktabe, Mohammad Sahebkar. (2019). Effect of Topical Chamomile Oil (Matricaria chamomile L.) as a Supplementary Method on Colic Symptoms in Infants: A Randomized Placebo-controlled Clinical Trial. Iran J Neonatol. 10 (1): 15-19. doi: 10.22038/ijn.2019.32270.1448.

Hastroenterolohiia ditei rannoho viku. Za red. OH Shadrina, OM Mukvich. (2010). Dovidnyk likaria «Dytiachyi hastroenteroloh». L: TOV «Doktor Media». Seriia «Zdorov'ia Ukrainy»: 216.

Holm LV, Jarbol DE, Christensen HW, Sondergaard J, Hestbaek L et al. (2018). The effect of chiropractic treatment on infantile colic: study protocol for a singleblind randomized controlled trial. Chiropractic&Manual Therap. 26: 17. https://doi.org/10.1186/s12998-018-0188-9; PMid:29930798 PMCid:PMC5991429

Iwanczak B, Iwanczak F. (2017). Zaburzenia czynnosciowe przewodu pokarmowego u niemowlat i malych dzieci. IV Kryteria Rzymskie. Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego. 43 (253): 35—40.

Kianifar Hamidreza, Ahanchian Hamid, Grover Zubin et al. (2014). Synbiotic in the management of infantile colic: A randomised controlled trial. Journal of Paediatrics and Child Health. 50 (10): 801-805. https://doi.org/10.1111/jpc.12640; PMid:24962875

Koppen IJN, Nurko S, Saps M, Di Lorenzo C, Benninga MA. (2017). The pediatric Rome IV criteria: what's new? Expert Review of Gastroenterology&Hepatology. 11 (3): 193-201. https://doi.org/10.1080/17474124.2017.1282820; PMid:28092724

Lee YY, Hassan SA, Ismail IH, Chong SY, Ali RAR, Nordin SA, Lee WS and Majid NA. (2017). Gut microbiota in early life and its influence on health and disease: A position paper by the Malaysian Working Group on Gastrointestinal Health. J Paediatr Child Health. 53: 1152-1158. https://doi.org/10.1111/jpc.13640; PMid:29205651

Leppalehto E, Partty A, Kalliomaki M et al. (2018). Maternal Intrapartum Antibiotic Administration and Infantile Colic: Is there a Connection? Neonatology. 114 (3): 226-229. https://doi.org/10.1159/000489991; PMid:29940563

Mai T, Fatheree NY, Gleason W, Liu Y, Rhoads JM. (2018). Infantile Colic New Insights into an Old Problem. Infantile Colic New Insights into an Old Problem.Gastroenterology Clinics of North America. 47 (4): 829-844. https://doi.org/10.1016/j.gtc.2018.07.008; PMid:30337035 PMCid:PMC6659398

Marimuthu M. (2019). Young mothers' acceptance of herbal food supplements: Centred on preventive health behaviour for children. Journal of Retailing and Consumer Services. 51: 311-319. https://doi.org/10.1016/j.jretconser.2019.06.019

Oosterloo, Berthe C, van Elburg, Ruurd M, Rutten, Nicole B et al. (2018). Wheezing and infantile colic are associated with neonatal antibiotic treatment. Pediatric Allergy and Immunology. 29 (2): 151-158. https://doi.org/10.1111/pai.12857; PMid:29314334

Perry R, Leach V, Penfold C, Davies P. (2019). An overview of systematic reviews of complementary and alternative therapies for infantile colic. Systematic Reviews. 8 (1): е271. https://doi.org/10.1186/s13643-019-1191-5; PMid:31711532 PMCid:PMC6844054

Quartieri A, De Marco A, Garro M, Amaretty A, Raimondi S, Simone M et al. (2017). Comparison of formula-fed infants with and without colic revealed significant differences in total bacteria, Enterobacteriaceae and faecal ammonia. Acta Paediatrica. 106: 573-578. https://doi.org/10.1111/apa.13642; PMid:27763733

Salehipoor H, Afzali B, Akrami R, Ghorat F, Niktabe Z, Sahebkar M. (2019). Effect of Topical Chamomile Oil (Matricaria chamomile L.) as a Supplementary Method on Colic Symptoms in Infants: A Randomized Placebo-controlled Clinical Trial. Iranian Journal of Neonatology. 10 (1): 15—22. doi: 10.22038/ijn.2019.32270.1448.

Shahramian I, Bazi A, Sargazi Alireza et al. (2018). Clinical Relevance of Faecal Calprotectin Level in Infantile Colic: A Cross-sectional Survey. Iranian Journal of Neonatology. 9 (4): 66—71.

Skjeie H, Skonnord T, Brekke M, Klovning A, Fetveit A, Landgren K, Hallstrom IK, Brurberg KG. (2018). Acupuncture treatments for infantile colic: a systematic review and individual patient data meta-analysis of blinding test validated randomised controlled trials. Scand J Primary Health Care. 36 (1): 56—69. https://doi.org/10.1080/02813432.2018.1426146; PMid:29338487 PMCid:PMC5901442.

Tatari Maryam, Charati Yazdani J, Karami Hassan et al. (2017). Effect of Probiotics on Infantile Colic Using the Quadratic Inference Functions. Iranian Journal of Neonatology. 8 (3): 66—71.

Vandenplas Y, Ludwig T, Bouritius H, Alliet P, Forde D, Peeters S, Huet F, Hourihane J. (2017). Randomised controlled trial demonstrates that fermented infant formula with short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides reduces the incidence of infantile colic. Act Pediatr. 106: 1150—1158. https://doi.org/10.1111/apa.13844; PMid:28328065 PMCid:PMC5485044

Wauters L, Brown T, Venter C, Dziubak R, Meyer R, Brogan B et al. (2016). Cow's Milk Allergy Prescribing Is Influenced by Regional and National Guidance. JPGN. 62 (5): 765—770. https://doi.org/10.1097/MPG.0000000000001052; PMid:26628440

Wegh CAM, Schoterman MHC, Vaughan EE, Belzer C, Benninga MA. (2017). The effect of fiber and prebiotics on children's gastrointestinal disorders and microbiome. Expert Rev.Gastroenterol. Hepatol. 11 (7—12): 1031—1045. https://doi.org/10.1080/17474124.2017.1359539; PMid:28737484.

Wessel MA, Cobb JC, Jackson EB et al. (1954). Paroxysmal fussing in infancy, sometimes called «colic». Pediatrics. 14: 421—435.

Wolke D, Bilgin A, Samara M. (2017). Systematic Review and Meta-Analysis: Fussing and Crying Durations and Prevalence of Colic in Infants. J Pediatrics. 185: 56—60. https://doi.org/10.1016/j.jpeds.2017.02.020; PMid:28385295

Y Fatheree N, Liu Y, Ferris M, Van Arsdall M, McMurtry V, Zozaya M et al. (2016). Hypoallergenic formula with Lactobacillus rhamnosus GG for babies with colic: A pilot study of recruitment, retention, and fecal biomarkers. World J Gastrointest Pathophysiol. 7 (1): 160—170. https://doi.org/10.4291/wjgp.v7.i1.160; PMid:26909239 PMCid:PMC4753182.

Yakovenko M, Kleschenko E, Kayumova D. (2018). Funktsionalnyie narusheniya zheludochno-kishechnogo trakta u detey, rozhdennyih s ochen nizkoy i ekstremalno nizkoy massoy tela, s gipoksicheski-ishemicheskoy entsefalopatiey na pervom godu zhizni. Pediatriya. Zhurnal im GN Speranskogo. 97 (3): 180—186.

Published

2020-09-29