Pathology
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Fetopathology and developmental pathology of the embryo and fetus
Marta Ježová, Josef Feit et al.
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Congenital tumors
Marta Ježová
Introduction

Congenital tumors are very rare. The definition includes benign and malignant tumors diagnosed in utero, in a newborn or during the first months of life. The most common congenital tumors except for hemangioma are the teratoma, various soft tissue neoplasms, leukemia, brain tumors and renal neoplasms.

Clinical signs

Common symptoms of congenital tumors:

  • many congenital tumors have benign biological behavior
  • the tumors grow fast because they are formed by immature tissues
  • malignant tumors are less agressive than expected and may undergo a spontaneous regression
  • prognosis of a congenital malignant tumor is better than for the identical tumor in an older child
  • tumors can be large enough to prevent the vaginal delivery
  • fatal prognosis can be a result of the tumor localisation or size, not its malignant behavior (e.g. brain teratoma resulting in obstructive hydrocephalus and compression of important brain centers)
  • congenital tumors are associated with hydrops
Classification
  • Teratomas:mixed germinal cells neoplasms
  • Hamartomas: benign lesions composed of excess of tissues that are normally found in the site of origin (congenital hemangioma, melanocytic nevi)
  • Blastomas:neoplasm imitating embryonic or fetal tissues (neuroblastoma, hepatoblastoma)

Disseminated blastoma, brain (71926)

Congenital teratoma, brain (72150)

Etiology
  • genetic: known in some cases (congenital leukemia at trisomy 21, familiar retinoblastoma)
  • unknown:e.g. teratomas
Pictures

Disseminated blastoma, brain, newborn: Disseminated blastoma, brain, Macro (71914) Disseminated blastoma, brain, Macro (71919) Disseminated blastoma, brain, Macro (71921) Disseminated blastoma, brain, Macro (71922) Disseminated blastoma, brain, Macro (71923) Disseminated blastoma, brain, Macro (71924) Disseminated blastoma, brain, Macro (71925) Disseminated blastoma, brain, Macro (71926) Disseminated blastoma, brain, Macro (71916)

Obstructive hydrocephalus with congenital teratoma of the brain, 34-week newborn: Hydrocephalus in congenital teratoma, Macro, autopsy (72143) Congenital teratoma of the CNS, Macro, autopsy (72150)

Sacrococcygeal teratoma
Congenital cardiac rhabdomyoma