Congenital Orbital Teratoma: A case report with fetal presentation

Congenital Orbital Teratoma: A case report with fetal presentation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Congenital Orbital Teratoma: A case report with fetal presentation Matthew Wheeler, Kelly Pergoretti, Sri Gore, Felice D'Arco, Ashirward Merve, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1553431/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Congenital orbital teratomas are rare entities with few case reports detailing their prenatal and perinatal imaging features. We present the case of a congenital orbital teratoma initially detected as cystic lesion on prenatal ultrasound, with fetal and postnatal imaging showing evolution of characteristic MRI appearances. Knowledge of these appearances and the ability to diagnose these rare entities in fetal life can aid management and operative planning in the immediate postnatal period. Congential Orbital teratoma Fetal MRI Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction: Teratomas are congenital tumours derived from the three germ layers. Although rare, the orbit is a recognised location for congenital teratoma 1 . Case Report: We present a case of a congenital orbital teratoma, initially discovered as an incidental cystic lesion in the right orbit during antenatal ultrasound scan. A fetal MRI performed at 27 weeks of gestation demonstrated a large, thin-walled and well-defined cystic lesion within the right orbit, causing significant proptosis of the globe, stretching of the extraocular muscles and optic nerve, expansion and remodelling of the bony orbit (Figs A-C). At this time point there were no visible septations, solid components, fat or blood products demonstrated. The intracranial and the left orbital structures were normal. A follow-up fetal MRI study was performed at 36 weeks of gestational age. This demonstrates significant structural changes of the cystic lesion in the right orbit, with reduction in the degree of proptosis, interval development of septations, and multiple small solid components posterior to the globe (Figs D and E). Post-processed 3D super-resolution reconstructed (SRR) images were performed for both Fetal MRI scans which provided further information regarding the transformation of the cyst between the 9 weeks interval, especially providing a clear overview of the volume of the lesion in relation to the whole head. This was particularly useful information during multidisciplinary meetings for delivery plan and also for parental counselling. The baby was subsequently delivered via caesarean section at 38 weeks, with multidisciplinary assistance at birth, including obstetric, anaesthetic and ophthalmology support to ensure maximal preservation of the affected eye (Figure F). On day 2 of life approximately 7mls of straw-coloured fluid was sampled. At day 8 of life a contrast-enhanced MRI head was performed with dedicated orbital sequences. This demonstrates a further reduction in the degree of proptosis and an increase in solid components, which showed contrast enhancement following gadolinium administration. Furthermore, T1-weighted fat saturated images show regions of signal dropout within the orbital lesion consistent with macroscopic fat (Figs G-J). The lesion was confined to the orbit with no evidence of any intracranial extension. At day 9 of life exenteration was performed, with removal of the globe and excision of the orbital lesion as a single specimen. The orbital cavity was markedly expanded and distorted, with bony remodelling and widening of the optic canal. Pathology examination (Figure K) revealed a firm grey tumour measuring approximately 3.5 cm in diameter, containing cystic and solid elements. The histology confirmed presence of mature tissue representing embryonic layers ectoderm, mesoderm and endoderm. These included patches of mature neuroglial tissue, mesenchymal tissue comprising adipose and cartilage tissue, skin adnexal structures and intestinal-type tissue. There were no immature elements or features of malignancy noted. The overall features are consistent with that of a mature (benign) cystic teratoma. The exenterated right eye showed no significant pathology. There were no immediate perioperative complications and the patient went on to have oculoplastic reconstruction which is currently ongoing (Figure I). Discussion: Teratomas are congenital germ cell tumours composed of all three germ cell layers (endoderm, ectoderm, mesoderm). Histopathological classification characterise as either mature teratoma, composed of fully differentiated cell types, or immature teratoma, containing undifferentiated tissues. Whereas mature teratomas generally behave as a benign tumour after complete resection, immature teratomas follow a more aggressive course with a greater propensity for recurrence 2 . This case posed a diagnostic challenge due to the findings of a large, thin-walled and well-defined cystic orbital mass on initial MRI imaging, with no suggestion of solid, fatty or haemorrhagic components at 27 weeks of gestation. The differential for these appearances is wide and include congenital orbital cysts, venolymphatic malformations, and rare entities such as optic nerve sheath meningoceoeles 3 . The rapid metamorphosis from an orbital cystic lesion in fetal life, to the development of solid and enhancing components postnatally, has recently been reported separately 4 , and this finding may reflect the natural history of orbital teratomas. This case demonstrates this transformation in utero, highlighting the importance of in-utero MR imaging follow-up in the presence of undefined orbital cystic lesion, to improve diagnostic accuracy, to assist on parental counselling and to guide for birth planning. Furthermore, this case highlights the importance of utilising dedicated post-natal MR orbital protocol, including the use of pre- and post-contrast T1-weighted images, both with and without fat saturation, to allow detection of macroscopic fat, a key feature of germ cell tumours. Declarations: This is a retrospective case report and ethical approval was not required. Parental consent was obtained for article submission and for permission to use the provided photographs. Availability of data and materials: Not applicable Competing interests: Not applicable Funding: Not applicable Authors' contributions: All the authors have made substantive contributions to the article and assume full responsibility for its content Acknowledgements: Not applicable References: Ahnoux-Zabsonre A, Sanou J, Lankoandé YF, Bouda C, Méda G, Lamien-Sanou A. Prenatal Exophthalmia Revealing a Postnatal Orbital Teratoma. Case Rep Ophthalmol Med. 2020 Jul 13;2020:1597353. doi: 10.1155/2020/1597353. Mann JR, Gray ES, Thornton C, Raafat F, Robinson K, Collins GS, Gornall P, Huddart SN, Hale JP, Oakhill A; UK Children's Cancer Study Group Experience. Mature and immature extracranial teratomas in children: the UK Children's Cancer Study Group Experience. J Clin Oncol. 2008 Jul 20;26(21):3590-7. doi: 10.1200/JCO.2008.16.0622. Pahwa S, Sharma S, Das CJ, Dhamija E, Agrawal S. Intraorbital Cystic Lesions: An Imaging Spectrum. Curr Probl Diagn Radiol. 2015 Sep-Oct;44(5):437-48. doi: 10.1067/j.cpradiol.2015.03.003. Epub 2015 Mar 17. Moré GHM, Vieira J, Akaishi PMS, Cruz AAV. Orbital Teratoma: MRI Changes From Fetal Life to Exenteration. Ophthalmic Plast Reconstr Surg. 2020 Mar/Apr;36(2):e58. doi: 10.1097/IOP.0000000000001430. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 31 May, 2022 Reviewers agreed at journal 21 May, 2022 Reviewers invited by journal 14 May, 2022 Editor assigned by journal 14 May, 2022 Submission checks completed at journal 09 May, 2022 First submitted to journal 13 Apr, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1553431","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":104500641,"identity":"df43dcdb-5753-4e09-bd6c-2e9ea3f8d693","order_by":0,"name":"Matthew 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Trust","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Kelly","middleName":"","lastName":"Pergoretti","suffix":""},{"id":104500643,"identity":"805ade13-9263-4918-b447-2cedc1ea111d","order_by":2,"name":"Sri Gore","email":"","orcid":"","institution":"Great Ormond Street Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sri","middleName":"","lastName":"Gore","suffix":""},{"id":104500644,"identity":"385a1d62-2144-4104-83cb-86ddbbdcab68","order_by":3,"name":"Felice D'Arco","email":"","orcid":"","institution":"Great Ormond Street Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Felice","middleName":"","lastName":"D'Arco","suffix":""},{"id":104500645,"identity":"6acdb7e9-7188-4b41-9980-01684d558ebf","order_by":4,"name":"Ashirward Merve","email":"","orcid":"","institution":"Great Ormond Street Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Ashirward","middleName":"","lastName":"Merve","suffix":""},{"id":104500646,"identity":"5f5306c1-ec00-444b-b0a1-06cea069657a","order_by":5,"name":"Kshitij Mankad","email":"","orcid":"","institution":"Great Ormond Street Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Kshitij","middleName":"","lastName":"Mankad","suffix":""}],"badges":[],"createdAt":"2022-04-13 08:59:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-1553431/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1553431/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":21672777,"identity":"ad04d475-ca36-4ce2-8b01-dfb693cda361","added_by":"auto","created_at":"2022-05-19 16:25:28","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":74817,"visible":true,"origin":"","legend":"\u003cp\u003eA, B and C: T2 HASTE images from fetal MRI at 27 weeks of gestational age demonstrate a large cystic orbital lesion causing significant proptosis of the right globe and marked stretching and thinning of the extraocular muscles and optic nerve.\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-1553431/v1/32c0e9c2eb90afac7b009019.jpg"},{"id":21671894,"identity":"e9d57fc6-47ce-4328-9e82-05845732232d","added_by":"auto","created_at":"2022-05-19 16:20:28","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":51036,"visible":true,"origin":"","legend":"\u003cp\u003eD and E: T2 HASTE images from a followup fetal MRI performed at 36 weeks of gestational age demonstrate a reduction in the degree of proptosis of the right globe, and interval development of multiple complex solid components within the orbit.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-1553431/v1/9d81dbe932fe57ab157fcea2.jpg"},{"id":21671897,"identity":"8c58f27a-dd71-4278-9afd-71a8fa36b0c5","added_by":"auto","created_at":"2022-05-19 16:20:28","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":70364,"visible":true,"origin":"","legend":"\u003cp\u003eF: Appearances of the right orbit immediately after delivery, with marked proptosis and multiple cystic componenets demonstrated.\u0026nbsp;\u003c/p\u003e","description":"","filename":"Figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-1553431/v1/8ffabde70876738ef1ce0f0f.jpg"},{"id":21671899,"identity":"ef72d831-2735-41ac-b332-ea23619e35f8","added_by":"auto","created_at":"2022-05-19 16:20:28","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":120228,"visible":true,"origin":"","legend":"\u003cp\u003eG, H, I and J: T1 weighted images with (G and H) and without fat-saturation (I and J) demonstrate areas of signal dropout (arrows) within the righ orbit consistent with macroscopic fat components. T1 fat-saturated post-contrast image deomstrates multiple solid enhancing components within the orbit. The degree of proptosis, and size of the cystic component, has reduced since the prenatal MRI imaging.\u003c/p\u003e","description":"","filename":"Figure4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-1553431/v1/9345de6b9702128eccef7e98.jpg"},{"id":21672776,"identity":"fee12e71-6860-4a88-92b2-aa708da76668","added_by":"auto","created_at":"2022-05-19 16:25:28","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":233431,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eK: Pathology confirming a mature benign cystic teratoma.\u003c/strong\u003e (A) Macroscopic cut section showing a multi-loculated lesion with cystic change (asterisk) and surrounding solid elements. The lesion appears to be well contained within the peripheral inked resection margins. (B) Low magnification histology section of the lesion approximately representing the macroscopic image (A), showing cystic (asterisk) and solid elements. The solid part contained mature tissue derivatives from all three germ layers - ectoderm, mesoderm and endoderm. (C-F) Higher magnification histology images showing neuroglial tissue (C), mesenchymal tissue (D) comprising cartilage (right) and adipose (left) tissue, skin adnexal structures including hair follicles (E), and intestinal-type epithelium (F). Other tissue such as collection of ganglionic cells, peripheral nerve and skeletal muscle tissue were also present (not shown). There was no immature element noted. There is no evidence of malignancy.\u0026nbsp;\u0026nbsp;\u003c/p\u003e","description":"","filename":"Figure5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-1553431/v1/6eacb7957f5c5098308759b3.jpg"},{"id":21671895,"identity":"9aa38bf2-6972-47a8-a797-939412dd6122","added_by":"auto","created_at":"2022-05-19 16:20:28","extension":"jpg","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":125019,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eI\u003c/strong\u003e: 1 year post-operative clinical photo demonstrating right periocular rehabilative status.\u0026nbsp;The lids comprise of orbicularis and skin only but will require further reconstruction.\u0026nbsp;The posterior socket has been reconstructed from dermis fat grafts, which are now supporting a clear prosthetic shell.\u0026nbsp;A painted prosthetic will be custom made for her. Further micro-fat pearl grafting will be performed to reduce facial asymmetry.\u0026nbsp;\u003c/p\u003e","description":"","filename":"Figure6.jpg","url":"https://assets-eu.researchsquare.com/files/rs-1553431/v1/881dd23b37bbb8169bbdc40c.jpg"},{"id":21672778,"identity":"61869355-bcdb-42b6-ad6c-97fcac5f48d8","added_by":"auto","created_at":"2022-05-19 16:25:31","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":573510,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1553431/v1/6fb0ae14-953b-4019-9f33-5c6eeaee75e1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Congenital Orbital Teratoma: A case report with fetal presentation","fulltext":[{"header":"Introduction:","content":"\u003cp\u003eTeratomas are congenital tumours derived from the three germ layers. Although rare, the orbit is a recognised location for congenital teratoma\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Case Report:","content":"\u003cp\u003eWe present a case of a congenital orbital teratoma, initially discovered as an incidental cystic lesion in the right orbit during antenatal ultrasound scan.\u003c/p\u003e \u003cp\u003eA fetal MRI performed at 27 weeks of gestation demonstrated a large, thin-walled and well-defined cystic lesion within the right orbit, causing significant proptosis of the globe, stretching of the extraocular muscles and optic nerve, expansion and remodelling of the bony orbit (Figs A-C). At this time point there were no visible septations, solid components, fat or blood products demonstrated. The intracranial and the left orbital structures were normal.\u003c/p\u003e \u003cp\u003eA follow-up fetal MRI study was performed at 36 weeks of gestational age. This demonstrates significant structural changes of the cystic lesion in the right orbit, with reduction in the degree of proptosis, interval development of septations, and multiple small solid components posterior to the globe (Figs D and E).\u003c/p\u003e \u003cp\u003ePost-processed 3D super-resolution reconstructed (SRR) images were performed for both Fetal MRI scans which provided further information regarding the transformation of the cyst between the 9 weeks interval, especially providing a clear overview of the volume of the lesion in relation to the whole head. This was particularly useful information during multidisciplinary meetings for delivery plan and also for parental counselling.\u003c/p\u003e \u003cp\u003eThe baby was subsequently delivered via caesarean section at 38 weeks, with multidisciplinary assistance at birth, including obstetric, anaesthetic and ophthalmology support to ensure maximal preservation of the affected eye (Figure F). On day 2 of life approximately 7mls of straw-coloured fluid was sampled. At day 8 of life a contrast-enhanced MRI head was performed with dedicated orbital sequences. This demonstrates a further reduction in the degree of proptosis and an increase in solid components, which showed contrast enhancement following gadolinium administration. Furthermore, T1-weighted fat saturated images show regions of signal dropout within the orbital lesion consistent with macroscopic fat (Figs G-J). The lesion was confined to the orbit with no evidence of any intracranial extension.\u003c/p\u003e \u003cp\u003eAt day 9 of life exenteration was performed, with removal of the globe and excision of the orbital lesion as a single specimen. The orbital cavity was markedly expanded and distorted, with bony remodelling and widening of the optic canal.\u003c/p\u003e \u003cp\u003ePathology examination (Figure K) revealed a firm grey tumour measuring approximately 3.5 cm in diameter, containing cystic and solid elements. The histology confirmed presence of mature tissue representing embryonic layers ectoderm, mesoderm and endoderm. These included patches of mature neuroglial tissue, mesenchymal tissue comprising adipose and cartilage tissue, skin adnexal structures and intestinal-type tissue. There were no immature elements or features of malignancy noted. The overall features are consistent with that of a mature (benign) cystic teratoma. The exenterated right eye showed no significant pathology.\u003c/p\u003e \u003cp\u003eThere were no immediate perioperative complications and the patient went on to have oculoplastic reconstruction which is currently ongoing (Figure I).\u003c/p\u003e"},{"header":"Discussion:","content":"\u003cp\u003eTeratomas are congenital germ cell tumours composed of all three germ cell layers (endoderm, ectoderm, mesoderm). Histopathological classification characterise as either mature teratoma, composed of fully differentiated cell types, or immature teratoma, containing undifferentiated tissues. Whereas mature teratomas generally behave as a benign tumour after complete resection, immature teratomas follow a more aggressive course with a greater propensity for recurrence\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eThis case posed a diagnostic challenge due to the findings of a large, thin-walled and well-defined cystic orbital mass on initial MRI imaging, with no suggestion of solid, fatty or haemorrhagic components at 27 weeks of gestation. The differential for these appearances is wide and include congenital orbital cysts, venolymphatic malformations, and rare entities such as optic nerve sheath meningoceoeles \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. The rapid metamorphosis from an orbital cystic lesion in fetal life, to the development of solid and enhancing components postnatally, has recently been reported separately \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e, and this finding may reflect the natural history of orbital teratomas. This case demonstrates this transformation in utero, highlighting the importance of in-utero MR imaging follow-up in the presence of undefined orbital cystic lesion, to improve diagnostic accuracy, to assist on parental counselling and to guide for birth planning. Furthermore, this case highlights the importance of utilising dedicated post-natal MR orbital protocol, including the use of pre- and post-contrast T1-weighted images, both with and without fat saturation, to allow detection of macroscopic fat, a key feature of germ cell tumours.\u003c/p\u003e"},{"header":"Declarations:","content":"\u003cp\u003eThis is a retrospective case report and ethical approval was not required. Parental consent was obtained for article submission and for permission to use the provided photographs.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials: Not applicable\u003c/p\u003e\n\u003cp\u003eCompeting interests: Not applicable\u003c/p\u003e\n\u003cp\u003eFunding: Not applicable\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions: All the authors have made substantive contributions to the article and assume full responsibility for its content\u003c/p\u003e\n\u003cp\u003eAcknowledgements: Not applicable\u003c/p\u003e"},{"header":"References:","content":"\u003col\u003e\n \u003cli\u003eAhnoux-Zabsonre A, Sanou J, Lankoand\u0026eacute; YF, Bouda C, M\u0026eacute;da G, Lamien-Sanou A. Prenatal Exophthalmia Revealing a Postnatal Orbital Teratoma. Case Rep Ophthalmol Med. 2020 Jul 13;2020:1597353. doi: 10.1155/2020/1597353.\u003c/li\u003e\n \u003cli\u003eMann JR, Gray ES, Thornton C, Raafat F, Robinson K, Collins GS, Gornall P, Huddart SN, Hale JP, Oakhill A; UK Children\u0026apos;s Cancer Study Group Experience. Mature and immature extracranial teratomas in children: the UK Children\u0026apos;s Cancer Study Group Experience. J Clin Oncol. 2008 Jul 20;26(21):3590-7. doi: 10.1200/JCO.2008.16.0622.\u003c/li\u003e\n \u003cli\u003ePahwa S, Sharma S, Das CJ, Dhamija E, Agrawal S. Intraorbital Cystic Lesions: An Imaging Spectrum. Curr Probl Diagn Radiol. 2015 Sep-Oct;44(5):437-48. doi: 10.1067/j.cpradiol.2015.03.003. Epub 2015 Mar 17.\u003c/li\u003e\n \u003cli\u003eMor\u0026eacute; GHM, Vieira J, Akaishi PMS, Cruz AAV. Orbital Teratoma: MRI Changes From Fetal Life to Exenteration. Ophthalmic Plast Reconstr Surg. 2020 Mar/Apr;36(2):e58. doi: 10.1097/IOP.0000000000001430.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"childs-nervous-system","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"cnsy","sideBox":"Learn more about [Child's Nervous System](http://link.springer.com/journal/381)","snPcode":"381","submissionUrl":"https://submission.nature.com/new-submission/381/3","title":"Child's Nervous System","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Congential Orbital teratoma, Fetal MRI ","lastPublishedDoi":"10.21203/rs.3.rs-1553431/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1553431/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eCongenital orbital teratomas are rare entities with few case reports detailing their prenatal and perinatal imaging features. We present the case of a congenital orbital teratoma initially detected as cystic lesion on prenatal ultrasound, with fetal and postnatal imaging showing evolution of characteristic MRI appearances. Knowledge of these appearances and the ability to diagnose these rare entities in fetal life can aid management and operative planning in the immediate postnatal period.\u003c/p\u003e","manuscriptTitle":"Congenital Orbital Teratoma: A case report with fetal presentation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-05-19 16:20:26","doi":"10.21203/rs.3.rs-1553431/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2022-05-31T15:26:52+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"a103dddc-2a71-43b7-aab8-51adbf837700","date":"2022-05-21T23:27:58+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2022-05-14T08:09:04+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2022-05-14T07:42:10+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2022-05-09T07:33:10+00:00","index":"","fulltext":""},{"type":"submitted","content":"Child's Nervous System","date":"2022-04-13T08:44:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"childs-nervous-system","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"cnsy","sideBox":"Learn more about [Child's Nervous System](http://link.springer.com/journal/381)","snPcode":"381","submissionUrl":"https://submission.nature.com/new-submission/381/3","title":"Child's Nervous System","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"f63805df-55c5-4a3c-b7ad-545e5a0fa990","owner":[],"postedDate":"May 19th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2022-06-01T17:14:10+00:00","versionOfRecord":[],"versionCreatedAt":"2022-05-19 16:20:26","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1553431","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1553431","identity":"rs-1553431","version":["v1"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}