Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis
Abstract Introduction Most often, ganglioneuromas affect older pediatric and adult patients. They are typically slow growing tumors that remain clinically silent until they become large enough to cause symptoms by compression of adjacent structures. Case We report a case of...
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doaj-04caf0dd17954187bbedfc8831f5334c2020-11-25T03:51:35ZengThieme Medical Publishers, Inc.American Journal of Perinatology Reports2157-69982157-70052014-04-0140104905410.1055/s-0034-1371751Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops FetalisPaul Singh0Cristiano Jodicke1Tara Swanson2Dev Maulik3Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Missouri Kansas City School of Medicine, Kansas City, MissouriDivision of Maternal Fetal Medicine and Staff Physician, Department of Obstetrics and Gynecology, Children's Mercy Hospital, Fetal Health Center, University of Missouri Kansas City School of Medicine, Kansas City, MissouriDivision of Pediatric Cardiology, Department of Pediatrics, Children's Mercy Hospital, University of Missouri Kansas City School of Medicine, Kansas City, MissouriDepartment of Obstetrics and Gynecology, UMKC School of Medicine, Kansas City, MissouriAbstract Introduction Most often, ganglioneuromas affect older pediatric and adult patients. They are typically slow growing tumors that remain clinically silent until they become large enough to cause symptoms by compression of adjacent structures. Case We report a case of a 22-year-old Hispanic gravida 2 para 1 female patient who was found to have massive hydrops fetalis at 20 completed gestational weeks. Fetal echocardiography revealed a narrowed distal ductal arch and proximal descending aorta. Cesarean delivery was undertaken at 29 completed gestational weeks for refractory labor and nonreassuring fetal status. The neonate expired at 47 minutes of life despite aggressive resuscitation. At autopsy, multiple thoracic masses were found adjacent to a compressed proximal descending aorta. Histological and immunohistochemical analysis confirmed the diagnosis of a ganglioneuroma, a rare type of neural crest tumor. Discussion A variety of intrathoracic masses have previously been reported to cause hydrops fetalis including teratomas, fibrosarcomas, and lymphangiomas. To our knowledge, this case is the first description of hydrops fetalis caused by ganglioneuromas. We propose that multiple thoracic ganglioneuromas led to biventricular distal outflow tract obstruction and hydrops fetalis.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1371751ganglioneuromahydrops fetalisthoracicneuroblastoma |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Paul Singh Cristiano Jodicke Tara Swanson Dev Maulik |
spellingShingle |
Paul Singh Cristiano Jodicke Tara Swanson Dev Maulik Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis American Journal of Perinatology Reports ganglioneuroma hydrops fetalis thoracic neuroblastoma |
author_facet |
Paul Singh Cristiano Jodicke Tara Swanson Dev Maulik |
author_sort |
Paul Singh |
title |
Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis |
title_short |
Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis |
title_full |
Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis |
title_fullStr |
Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis |
title_full_unstemmed |
Thoracic Ganglioneuromas Resulting in Nonimmune Hydrops Fetalis |
title_sort |
thoracic ganglioneuromas resulting in nonimmune hydrops fetalis |
publisher |
Thieme Medical Publishers, Inc. |
series |
American Journal of Perinatology Reports |
issn |
2157-6998 2157-7005 |
publishDate |
2014-04-01 |
description |
Abstract
Introduction Most often, ganglioneuromas affect older pediatric and adult patients. They are typically slow growing tumors that remain clinically silent until they become large enough to cause symptoms by compression of adjacent structures.
Case We report a case of a 22-year-old Hispanic gravida 2 para 1 female patient who was found to have massive hydrops fetalis at 20 completed gestational weeks. Fetal echocardiography revealed a narrowed distal ductal arch and proximal descending aorta. Cesarean delivery was undertaken at 29 completed gestational weeks for refractory labor and nonreassuring fetal status. The neonate expired at 47 minutes of life despite aggressive resuscitation. At autopsy, multiple thoracic masses were found adjacent to a compressed proximal descending aorta. Histological and immunohistochemical analysis confirmed the diagnosis of a ganglioneuroma, a rare type of neural crest tumor.
Discussion A variety of intrathoracic masses have previously been reported to cause hydrops fetalis including teratomas, fibrosarcomas, and lymphangiomas. To our knowledge, this case is the first description of hydrops fetalis caused by ganglioneuromas. We propose that multiple thoracic ganglioneuromas led to biventricular distal outflow tract obstruction and hydrops fetalis. |
topic |
ganglioneuroma hydrops fetalis thoracic neuroblastoma |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1371751 |
work_keys_str_mv |
AT paulsingh thoracicganglioneuromasresultinginnonimmunehydropsfetalis AT cristianojodicke thoracicganglioneuromasresultinginnonimmunehydropsfetalis AT taraswanson thoracicganglioneuromasresultinginnonimmunehydropsfetalis AT devmaulik thoracicganglioneuromasresultinginnonimmunehydropsfetalis |
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1724486733547962368 |