TY - JOUR
T1 - Prenatally diagnosed neck masses
T2 - Long-term outcomes and quality of life
AU - Sheikh, Fariha
AU - Akinkuotu, Adesola
AU - Olutoye, Oluyinka O.
AU - Pimpalwar, Sheena
AU - Cassady, Christopher I.
AU - Fernandes, Caraciolo J.
AU - Ruano, Rodrigo
AU - Lee, Timothy C.
AU - Cass, Darrell L.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Purpose To determine long-term outcomes of fetuses with neck masses (NM), including functional and cosmetic results. Methods A retrospective review was performed of all fetuses evaluated for NM from November 2001 to March 2014. Quality of life (QOL) was evaluated using the validated PedsQL™ questionnaire. Results Of 35 fetuses evaluated, 9 died perinatally and 1 died late from tracheostomy complications. NM ranged from 4 to 20 cm (mean, 9.1 cm); 18 were delivered by EXIT. Of 25 surviving patients, 22 had mass resection, 7 requiring more than one procedure. Surviving patients with lymphatic malformations (LM) had the highest incidence of moderate and severe disfigurement and a higher rate of persistent/recurrent disease (100% vs. 31%, p = 0.002) and cranial nerve dysfunction (50% vs. 0%, p = 0.005) compared to those with non-LM diagnoses. Of 9 children attending school, 78% achieve grades of A/B's. QOL for 13 patients revealed a mean score of 83/100 for physical and 78/100 for psychosocial functioning. Median follow-up was 6 years (7 months-17 years). Conclusion Unlike those with teratoma or other lesions, children with congenital cervicofacial LM are at high-risk for persistent disease, nerve dysfunction and moderate-severe disfigurement. There is substantial perinatal morbidity for fetuses with neck masses, but for those surviving, the long-term functional and cognitive outcomes are good.
AB - Purpose To determine long-term outcomes of fetuses with neck masses (NM), including functional and cosmetic results. Methods A retrospective review was performed of all fetuses evaluated for NM from November 2001 to March 2014. Quality of life (QOL) was evaluated using the validated PedsQL™ questionnaire. Results Of 35 fetuses evaluated, 9 died perinatally and 1 died late from tracheostomy complications. NM ranged from 4 to 20 cm (mean, 9.1 cm); 18 were delivered by EXIT. Of 25 surviving patients, 22 had mass resection, 7 requiring more than one procedure. Surviving patients with lymphatic malformations (LM) had the highest incidence of moderate and severe disfigurement and a higher rate of persistent/recurrent disease (100% vs. 31%, p = 0.002) and cranial nerve dysfunction (50% vs. 0%, p = 0.005) compared to those with non-LM diagnoses. Of 9 children attending school, 78% achieve grades of A/B's. QOL for 13 patients revealed a mean score of 83/100 for physical and 78/100 for psychosocial functioning. Median follow-up was 6 years (7 months-17 years). Conclusion Unlike those with teratoma or other lesions, children with congenital cervicofacial LM are at high-risk for persistent disease, nerve dysfunction and moderate-severe disfigurement. There is substantial perinatal morbidity for fetuses with neck masses, but for those surviving, the long-term functional and cognitive outcomes are good.
KW - Cervical lymphatic malformation
KW - Cervical teratoma
KW - Cervical thyroid cyst
KW - Cervical vascular malformation
KW - Fetal neck mass
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U2 - 10.1016/j.jpedsurg.2015.02.035
DO - 10.1016/j.jpedsurg.2015.02.035
M3 - Article
C2 - 25863543
AN - SCOPUS:84952631552
SN - 0022-3468
VL - 50
SP - 1210
EP - 1213
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
IS - 7
ER -