Malignant and benign tumors in infants are rare, and when you notice a mass on a fetus during routine ultrasonography or notice symptoms in a fetus that might indicate a tumor, you may want to consult a physician who specializes in performing high-risk fetal and neonatal procedures.
Because children’s tumors are rare, they can be difficult to diagnose. Most fetal tumors are benign, but as the masses grow in utero, they can affect blood or air circulation in the developing fetus. Types of tumors diagnosed in a fetus and newborn include:
Abdominal tumors - Ovarian cysts rarely require fetal intervention, even when the cysts are complex. They should be closely monitored following the child’s birth and managed appropriately. Retroperitoneal masses are seldom found on fetal sonograms and rarely require fetal intervention. They should not be ignored, however, because their presence can indicate several diseases and conditions that need monitoring and may require intervention.
Cardiac tumors - These very rare tumors can be detected on fetal sonograms at a gestational age of about 22 weeks. The most common type of prenatal cardiac tumor is the rhabdomyoma, which can indicate additional problems for the infant. Teratomas, fibromas and vascular malformations also occur in the heart area.
Head and neck tumors - Cervical masses can cause serious complications in a fetus, especially because of airway obstruction and potential cardiac failure if the mass is highly vascular. Most cervical lesions are teratomas. They can be seen easily on fetal sonograms and a fetal MRI can provide diagnostic and treatment planning detail.
Pulmonary masses - The most common mass diagnosed prenatally is the congenital pulmonary airway malformation, or CPAM. With CPAM, the fetus has a multicystic mass, usually in a single lobe of a lung, such as the rare sacrococcygeal tumor. This tumor requires careful fetal monitoring and introduces particularly high risk at delivery.
Discovery of a fetal mass often requires a specialty consult or referral. Pregnancies complicated by large fetal masses, especially in the neck or lungs, require close monitoring and at minimum, a scheduled cesarean section delivery by a team of specialists trained in treating newborn tumors.
Some newborn tumors are best managed with an ex utero intrapartum treatment, or EXIT, procedure. Our surgeons can secure the newborn’s airway, resect the tumor and monitor and stabilize both mother and infant before cutting the umbilical cord and completing delivery.