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Case of the Week # 63

Fabrice Cuillier, MD and Jacques Bidault, MD

November 30-December 13, 2001

From the department of Obstetrics and Gynecology, Hôpital Félix Guyon, rue des Topazes, 97400 Saint-Denis, Reunion Island, France. Ph : 0262 90 55 22. Fax : 0262 90 77 30.

This 25 week fetus has an unusual finding in the neck. During swallowing the mass was pulled towards the retropharynx and its walls appeared soft and malleable.

Coronal view (on the right image the baby is oriented 180 degree to the orientation on the left image).

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Sagittal view

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Base of the mouth

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The normal heart and the stomach

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The prenatal MRI demonstrates the same findings:

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What is (are) the finding(s) and diagnosis ?

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Answer

This 25 week fetus has an unusual finding in the neck. During swallowing the mass was pulled towards the retropharynx and its walls appeared soft and malleable.

Coronal view (on the right image the baby is oriented 180 degree to the orientation on the left image). There is a fluid filled anterior structure, that moves during the deglutition.

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Sagittal view of the cystic structure.

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Base of the mouth

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The normal heart and the stomach that is a little small.

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The prenatal MRI demonstrates the same findings:

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case0063-8

Findings

The only finding was that of a small anterior neck cyst that moved with swallowing. The following lesions could be differential diagnosis:

  • epidermoid cyst,
  • dermoid cyst,
  • thyroglossal duct cyst,
  • mucocele,
  • enteric duplication cyst,
  • lingual bronchogenic cyst,
  • hemangioma,
  • cystic hygroma,
  • teratoma,
  • hamartoma,
  • lymphangioma and
  • thyroid remnant cyst

In this case the cyst corresponded to a vallecular cyst.

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