Intracardiac teratomas are rare primary tumours. We report the case of an infant prenatally diagnosed with an isolated multi-cystic mass developed in the right ventricle causing neonatal refractory ventricular arrhythmia. Despite rescue extracorporeal support and partial surgical resection, he died as almost all the previous reported perinatal intracardiac teratomas whatever the prenatal tolerance and the size of the tumour. The common poor outcome of fetal intracardiac teratomas should be known when counselling parents during pregnancy.

An intrapericardial vacuolated mass compressing and displacing the heart was diagnosed by echocardiography in a foetus of 22 weeks gestation. The birth was induced for early signs of foetal distress at 29 weeks and, after two initial pericardial evacuation procedures, the tumour was resected radically 7 days after birth at a weight of 1.55 kg. Mass histology showed teratoma associated with yolk sac tumour. We comment on the overall approach adopted after foetal diagnosis and the histopathological features of the tumour, and try to draw conclusions on patient outcome data.

We describe two cases of confirmed anti-NMDA receptor encephalitis; one patient initially presented with a clinical picture that resembled delirium and later appeared to present with a conversion reaction and the second patient presented with a first psychotic break followed by the clinical picture of neuroleptic malignant syndrome with catatonia. Neither patient had a previous history of psychiatric illness or recreational drug use. These cases illustrate the diagnostic and treatment challenges associated with this neuropsychiatric condition and underscore the role of psychosomatic medicine psychiatrists in diagnosing anti-NMDA receptor encephalitis.

Intrapericardial teratomas are extremely rare and most often benign tumours. In this paper, we have described a case of intrapericardial teratoma diagnosed prenatally and successfully operated. The presented case is noteworthy as an example of potentially catastrophic cardiorespiratory distress caused by the space-occupying nature of the tumour. A multi-disciplinary approach is mandatory because the tumour most often arises from the ascending aorta and in some cases may require the use of cardiopulmonary bypass.

A case is presented of a nine-month-old male infant who presented acutely with an anterior neck and mediastinum mass compressing the trachea. Radiological assessment by ultrasound, magnetic resonance imaging and computed tomography suggested the nature of the mass to be a lymphatic malformation (cystic hygroma). The excised specimen was revealed as a mature teratoma. The inability to distinguish between lymphatic malformation and teratoma on multi-imaging modalities confers a risk of mismanaging these lesions with the use of sclerotherapy; surgical excision is the necessary treatment. The potential consequences are discussed.

Teratomas and dermoids or hairy polyps of the head and neck are rare congenital tumours, often confused and reported to appear as single masses, that may cause upper aerodigestive tract impairment. Their histological classification, origin and embryological basis of development have been a topic of debate in the past and recent literature.

We report a case of an infant presenting with a multifocal bigerminal teratoma in the nasopharynx and the neck, causing a deep neck infection, and discuss the unique clinicopathological aspects of this case.

A choristoma is a benign tumour-like mass consisting of mature tissue derived from one or more germ cell layers that are foreign to the site at which they are located. Choristomas of the pharynx are rare with few cases being reported in the English literature. Management of these lesions is usually complete surgical excision. We report a case of osteocartilaginous choristoma arising from the pharynx.

We describe a case of a newborn baby with a prenatal diagnosis of an epignathus (oropharyngeal teratoma). With the potential for airway problems at birth, he was delivered by an elective EXIT (Extra Utero Intrapartum Treatment) procedure at 38 weeks of pregnancy. The airway was secured and rigid bronchoscopy performed. Initially he was stable, but developed cardiorespiratory difficulties 40 minutes after birth and died from a cardiac arrest 17 minuteslater. Tension pneumothorax is a devastating complication that can occur with lower airway manipulation for anaesthesia and rigid bronchoscopy. The addition of positive pressure during mechanical ventilation converts the pneumothorax into a tension pneumothorax. The possibility of tension pneumothorax should be entertained in a mechanically ventilated patient whose ventilatory pressures are increasing, with diminishing cardiac output. A complicated case is presented, where the diagnosis was missed with a fatal outcome.

A case of synchronous cystic teratomas presented with the complaints of a slow-growing facial mass and forward protrusion of the right eye since birth. The patient was examined thoroughly and subjected to magnetic resonance imaging (MRI) scan. The MRI scan revealed the presence of two separate cysts in the right orbit and right temporal fossa. The patient was operated by a combined effort of ophthalmologists and otorhinolaryngologists. The cysts were excised and subjected to pathological examination. The histopathological survey revealed both the cysts to be mature cystic teratomas similar to each other. This coexistence of a primary temporal fossa teratoma with an orbital teratoma is the first of its kind and to the best of our knowledge has not been reported before.

Hairy polyps are rare tumours that can occur anywhere in the body. They are especially rare in the pharynx. We report two cases of hairy polyps which originated from the nasopharynx. One presentedwith intermittent obstruction of the airway and the second presented as a visible pedunculated mass protruding from the mouth of a neonate.

Teratomas are germ cell tumours usually found in the young and are characteristically composed of tissue foreign to the place where they arise. Two teratomas of the middle ear were first described in 1866 and since then, and to the best of our knowledge, 19 additional cases have been reported in the literature under different terms such as hairy congenital polyps, epidermoid cysts, dermoid cysts, hamartoma, cutaneous teratoma and teratomas. The difficulty in classifying germ cell tumours may explain the different terminologies encountered in the literature. The authors describe a case of teratoma of the eustachian tube presenting as a mass in the middle and external ear of a 10-week-old girl. Using this case, a review of the literature is performed in light of the new classification of germ cell tumours proposed by the World Health Organization (WHO). It is of note that most of the teratomas that present in the middle ear arise from, or involve, the eustachian tube.

Malignant neoplasms of the nasal cavity and paranasal sinuses are uncommon. Choriocarcinoma is a highly malignant germ cell tumour occurring in the reproductive organs. Metastasis may be principally by the lymphatic route as in other germ cell tumours but choriocarcinoma is also known to spread haematogenously. We present a rare case of metastatic choriocarcinoma to the nasal cavity from testicular teratoma presenting with intractable epistaxis in a 32-year-old Caucasian male, who ultimately succumbed to this disease.