Written By: IJCP Editorial Team

Published On: 21 Aug, 2025 4:16 PM | Updated On: 22 Aug, 2025 11:14 PM

A Rare Case of Faciomandibular Teratoma with Unique Finger-Like Appearance

Introduction

Teratomas are rare congenital neoplasms containing tissues derived from all three germ layers. While sacrococcygeal teratomas are the most common, head and neck teratomas constitute only 2%–9% of all cases. Within this category, faciomandibular teratomas are exceedingly rare, with very few cases reported worldwide. Early diagnosis is critical due to potential airway obstruction and feeding difficulties.

Case Presentation

We report the case of a 3-month-old Nepalese infant who presented with a striking pedunculated growth arising from the chin, resembling an accessory finger. The lesion was present since birth and had gradually enlarged. The infant experienced difficulty during breastfeeding but no respiratory distress.

On examination, the mass measured approximately 4 cm in length, firm in consistency, non-tender, and covered by normal skin. Radiographic imaging revealed no bony involvement. Ultrasonography demonstrated a heterogeneous soft tissue mass without vascular invasion. Laboratory workup, including alpha-fetoprotein (AFP) levels, was within normal limits.

Surgical excision was performed under general anesthesia, and the mass was removed in toto. Histopathological examination confirmed a mature teratoma containing ectodermal (skin, hair follicles), mesodermal (cartilage, muscle), and endodermal (glandular) components. Postoperative recovery was uneventful, and the infant showed improved feeding and weight gain at follow-up.

Discussion

Faciomandibular teratomas are exceptionally rare congenital tumors. Their clinical presentation may mimic dermoid cysts, accessory digits, or other craniofacial malformations. Potential complications include airway obstruction, feeding difficulties, and cosmetic deformity. Imaging studies are essential to evaluate extent and exclude deeper involvement. Complete surgical excision remains the treatment of choice, with excellent prognosis in cases of mature teratoma.

Conclusion

This case highlights a rare presentation of faciomandibular teratoma manifesting as a finger-like projection on the chin of a Nepalese infant. Awareness of such atypical presentations is crucial for timely diagnosis and management, ensuring good functional and cosmetic outcomes.