HCMC – The patient in the first months of pregnancy in the mother’s womb still had no abnormalities detected. It was not until the baby was almost born that a tumor weighing 1.1kg was discovered.
Doctors operated on the pediatric patient, removing the lymphatic tumor. Photo: P.Lan
Pregnant woman T. (32 years old, Ho Chi Minh City) during her pregnancy was examined at an outside clinic and was diagnosed as normal. At the 31st week of pregnancy, after a fetal ultrasound and MRI scan, she discovered a large tumor. 6x6cm size, risk of compression in the chest area.
At the 37th week of pregnancy, the mother was assessed for a large tumor and the possibility of the baby having postpartum respiratory failure, requiring an elective cesarean section.
Doctor II Pham Le My Hanh – Head of the Department of Neonatology, Tam Anh General Hospital in Ho Chi Minh City said: “Ms. T.’s baby was born at the end of 2023, weighing 3.4 kg, tumor size 10×20 cm (weighing 1 kg). ) is equivalent to a newborn’s head, pulling the neck to one side.
There are many children born with huge tumors in the neck and chest area, causing severe respiratory failure. However, large tumors with intestinal obstruction (like Ms. T.’s) are very rare. This is the first case I have encountered in many years of practice because the baby has two major deformities in one body.”
According to Dr. Nguyen Do Trong, Pediatric Surgery Department, Tam Anh General Hospital, Ho Chi Minh City, the baby had a bloated stomach, spit up green fluid, did not digest milk, and did not have bowel movements. The doctor discovered a condition of neonatal intestinal obstruction that required emergency surgery to resolve the baby’s digestive tract circulation.
Congenital intestinal obstruction is caused by meconium plugs blocking the intestinal lumen. Secretions in the digestive tract are mucous and stick to the intestinal mucosa, causing feces to stagnate in the colon. The patient cannot have a bowel movement. Intestinal obstruction due to meconium accounts for up to 33% of cases of small bowel obstruction in newborns.
The baby will have a temporary anus opened on the abdomen, the intestine containing meconium below will be irrigated. After 2-3 months, waiting for the lower intestine to have enough time to dilate and the biopsy results of the intestine below the temporary anus will be normal. Intestinal suture and temporary anal closure. At that time, the baby can go to the toilet normally.
As for the tumor, although dangerous, it does not compress the airway. Because the baby is only 4 days old, many surgeries cannot be performed, so further monitoring is required.
After surgery to treat intestinal obstruction, the baby was fed intravenously with adequate nutrition and recovered quickly. However, the lymphoma progresses unfavorably, showing signs of infection. The tumor invaded the muscles of the chest and neck on the left side, surrounding the vascular and nerve bundles.
“If there is no surgery, if the tumor is too big, the baby will have a crooked head and neck, misaligned shoulders, and will compress the airway, causing respiratory failure and skin necrosis,” Dr. Trong said.
After tumor surgery, the baby ate and slept well, easily tilted and turned his head, and turned over on his own when he was 3 months old.
Lymphomas often form in the fetal stage or in children born under 5 years old. The cause of the disease has not yet been clearly determined. There are some studies that suggest that lymphoma is formed in the fetus due to improper development of the lymphatic system.