Asphyxia neonatorum due to a nasopharyngeal teratoma.

Although a nasopharyngeal teratoma occurs but rarely, it may be a cause of acute asphyxia in the newborn baby. The tumour is often readily amenable to surgical removal. Ehrich (1945) gives a comprehensive survey of the literature relating to teratoid parasites of the mouth. He refers to the earlier publications of Ahlfeld (1875), Arnold (1888) and Schwalbe (1907) and discusses their theories relating to the pathogenesis of such tumours. Ahlfeld believed they were all twin formations. Arnold classified them according to their state of development and agreed that the highly developed variety were true double monsters but believed the more simple type, the so-called hairy polyp, was a tissue malformation due to cell dislocation early in development. Schwalbe favoured a similar classification but considered that all had an identical pathogenesis and were caused by dislocation of germ material. The earlier in development this occurred the more complex was the resulting tumour. At the present time the pathogenesis of teratoma formation is based on the organizer theory of Spemann. Needham (1942) compares naturally occurring and experimentally induced teratomata and concludes that the malformations are only explicable as the result of uncoordinated organizer action. Not only must the liberation of evocator (stimulus) at times and places where it is not normally liberated be considered, but also competence to respond to evocator beyond the time at which it is normally lost. He concludes by stating that primary evocator is present in most adult tissues of animals in the free state and it is therefore likely that prolongation of the period of competence is a more important factor. It is evident that from them both, by all sorts of combinations and permutations, everything that we know of under the name of the teratomata may be produced. The present report is concerned with the simple type of teratoma or hairy polyp. Ehrich (1945) refers to 79 similar cases and references to II more have been found in the literature since that time.