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July 1990

Picture of the Month

Am J Dis Child. 1990;144(7):795-796. doi:10.1001/archpedi.1990.02150310063029

Denouement and Discussion 

Nasopharyngeal Teratomas 

Manifestations  Teratomas as a group are the most common of all congenital tumors, with an incidence of one in 4000 births. Teratomas located in the nasopharynx, however, are a much rarer congenital malformation and occur almost exclusively during infancy. The most common location of teratomas in childhood is the sacrococcygeal region.Nasopharyngeal teratomas in the newborn present as an extruding nasal mass associated with respiratory distress or neonatal asphyxia, recurrent episodes of coughing, and failure to gain weight.The extent of the clinical picture depends on the size and location of the tumor. Obstruction of the fetal pharynx may result in decreased fetal absorption of amniotic fluid causing polyhydramnios.Teratoid tumors of the nasopharynx may be divided into three categories: (1) dermoids-midline masses that contain two germ cell components; stratified squamous epithelium surrounding fat, muscle, cartilage, or bone. These are called "hairy