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November 1994

Pathological Case of the Month

Arch Pediatr Adolesc Med. 1994;148(11):1191-1192. doi:10.1001/archpedi.1994.02170110077013

A FULL-TERM infant boy was born to a 21-year-old, gravida 2, para 2 woman by spontaneous vaginal delivery. The infant had an Apgar score of 5/7 at 1 and 5 minutes, and the amniotic fluid was stained with meconium. Endotracheal intubation and suctioning were required. The infant boy developed respiratory distress and underwent reintubation. Supplemental oxygen and continuous positive airway pressure were given. On extubation, he developed severe respiratory distress and intercostal retractions. After admission to Kosair Children's Hospital (Louisville, Ky), further evaluation revealed a chubby infant boy with a thick neck but no distinct masses. Two days later, the right side of the neck was swollen with a bulging, spongy, nondiscrete mass measuring approximately 2×2 cm (Figure 1). The margins of the mass were not palpable. Roentgenograms and computed tomograms of the neck showed collapse of the hypopharynx and a huge soft-tissue mass involving the neck bilaterally. The cervical