Ex Utero Intrapartum Treatment (EXIT) in a rare infantile tongue fibrosarcoma and it’s management dilemma

Abstract

AbstractEx utero intrapartum treatment (EXIT) has been described as a safe procedure to secure challenging fetal airways while on placental support. Here we present an extremely rare case of huge infantile tongue fibrosarcoma diagnosed prenatally and successfully delivered via EXIT. Initial diagnosis of infantile tongue haemangioma was made based on physical examination, radiological findings and high incidence of infantile haemangioma in the first year of life hence trial of oral propranolol was given. Tracheostomy was performed at 1 week of life in anticipation of airway compromise and failed extubation. A biopsy of the tongue tumour was performed to rule out soft tissue malignancy. Histopathological examination (HPE) revealed a malignant tumour suggestive of infantile fibrosarcoma. The management of infantile fibrosarcoma is a multidisciplinary team’s involvement. However, non-mutilating surgery should be the primary treatment for infantile fibrosarcoma aiming for complete excision. Neoadjuvant chemotherapy is indicated when upfront resection is unfeasible as in the present case.

Keywords

• EXIT procedure
• infantile fibrosarcoma
• tongue
• soft tissue tumour