基于产前诊断的Neumann瘤的新生儿口腔肿瘤影像学特征与鉴别诊断

文献信息

中文摘要

新生儿先天性病变谱包括口腔内或口腔附近的各种软组织和硬组织肿块。虽然口腔裂通常在产前容易诊断并在出生后治疗，但其他危重情况可能需要新生儿立即干预。这些情况包括由后鼻孔闭锁、牙槽黏膜融合或减少气道容积的占位性病变引起的气道受损。此外，一些病变可能导致显著出血或干扰吸吮和喂养。在此类情况下，使用超声（USG）和磁共振（MR）成像进行仔细的产前评估对于确定手术干预的时机和策略至关重要。罕见病变的发生，例如先天性牙龈瘤，也称为Neumann瘤（NT），需要精确诊断以排除其他令人担忧的病理。对口角、舌、唇和牙龈区域的详细MR评估有助于确定病变的范围及其与邻近结构的解剖关系。尽管连续超声检查显示病变间期生长，但近足月MRI显示无咽部延伸或喉气管狭窄。未计划EXIT-to-airway（产时子宫外处理至气道）程序，分娩通过择期剖宫产进行，并有多学科气道支持可用。本报告强调，局部NT切除通常侧重于完整切除、评估肿瘤基底部以及评估周围牙槽骨。

英文摘要

The spectrum of congenital lesions in newborns includes various soft and hard tissue masses found within or near the oral cavity. While oral clefts are often easily diagnosed prenatally and treated after birth, other critical conditions may require immediate neonatal intervention. These include airway compromise resulting from choanal atresia, alveolar mucosal fusion, or space-occupying lesions that reduce airway volume. Furthermore, some lesions may cause significant bleeding or interfere with sucking and feeding. In such cases, careful prenatal evaluation using ultrasound (USG) and magnetic resonance (MR) imaging is essential to inform the timing and strategy of surgical interventions. The occurrence of a rare lesion, such as a congenital epulis, also known as a Neumann tumor (NT), requires precise diagnostics to exclude other worrisome pathologies. Detailed MR evaluation of the oral commissure, tongue, lips, and gingival area helps identify the lesion's extent and its anatomical relationship with adjacent structures. Although serial ultrasonography demonstrated interval growth, near-term MRI showed no pharyngeal extension or laryngotracheal narrowing. An EXIT-to-airway procedure was not planned, and delivery was performed by elective cesarean section with multidisciplinary airway support available. This report highlights that local NT removal typically focuses on complete excision, evaluation of the tumor base, and assessment of the surrounding alveolar bone.