Anesthesia management in a giant congenital undifferentiated
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Immature and malignant orbital teratomas are rare.They are characteristically massive, enlarging the orbit 2 or 3 times normal, and cause severe facial deformity and disfigurement including proptosis and eyelid stretching. Complication of teratoma includes cranio-orbital invasion that can be fatal if incompletely excised. General anaesthesia care, including tracheal intubation, is challenging in a 2-week neonate. It is even more difficult considering the presence of a huge exophytic orbital mass. An airway lesion or a difficult airway in this age group can be a nightmare for the physician managing the case.A 13-day-old female child weighing 3.2 kg, born of a full-term normal vaginal delivery presented with a large irregular swelling in the left orbit since birth. The mass looked multilobulated and was roughly 12 cm in length and extending from the orbit to the cheek, beyond the angle of mouth. It was slightly mobile and could be lifted off the face to uncover the mouth partly. Feeding was almost impossible. The child had no other congenital anomalies and was breathing normally. Magnetic resonance imaging revealed a large 11 cm × 9 cm × 4 cm lobulated mixed cystic intraorbital lesion with a large exophytic component suggestive of orbital teratoma.The child was posted for surgical excision of the mass...

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