World's first as doctors remove tumor from fetus' mouth

Miami - Leyna Gonzales was in the womb when doctors discovered through ultrasound that she had a tennis ball-sized tumor growing from her mouth. In a world first, surgeons from the University of Miami/Jackson Memorial successfully removed the oral teratoma.

Tammy Gonzalez was 17 weeks pregnant when she went for a fetal ultrasound and saw what she described as a "bubble coming out of my daughter's mouth." The bubble was in fact a oropharyngeal teratoma, a rare congenital tumor that only occurs in an estimated one in 35,000 to one in 200,000 live births. Gonzalez' gynecologist Jason James, gave the mother-to-be few options. She could terminate the pregnancy or go full-term with no guarantees that her daughter would be normal. The baby could face "numerous surgeries" and even physical deformities from the tumor which can "get up to two pounds," Gonzalez said yesterday at a press conference from Jackson Memorial Hospital. It was news that the mother was not prepared to accept. Gonzalez said that by 17 weeks, "this baby was already kicking," so there "had to be a way to save her." After conducting research on in-vitro surgery, Gonzalez queried whether anyone could surgically remove the tumor while the baby was still in the womb. She was given the name of Dr. Ruben Quintero, a UM/Jackson fetal surgeon who told the mom that "he did not do this type of surgery, because nobody had ever heard of it." Quintero said at the press conference, "the concern with these tumors is that they can grow very rapidly" and "can cause bleeding from the fetus - from the baby - into the tumor." This bleeding, he added, "can cause the death of the baby." But together with fellow fetal surgeon Dr. Eftichia Kontopoulous, also of Jackson Memorial Hospital, the two performed the surgery in May 2010. It was heralded as the "first of its kind in the world" and was published in the American Journal of Obstetrics and Gynecology. Using an endoscope guided by ultrasound, and a laser to cut the tumor, Quintero and Kontopoulous resected the mass and cleared the baby's mouth. The procedure was done at Jackson Memorial Hospital and lasted just over an hour. Gonzalez, who was awake throughout the procedure, said that watching the surgery was "amazing." When they finally severed the tumor she added, she could see it floating away and "this huge weight lifted off of me and I could finally see her face." On October 1, 2010, Leyna Mykaella Gonzalez was born healthy, weighing 8 pounds, 1 ounce. The proud mom said that Leyna had "no distortions, no cleft palate" and her baby was "Perfectly normal – thank God." According to Children's Hospital, Teratomas are congenital (present prior to birth) tumors formed by different types of tissue. In newborns they are generally benign and don't spread but they can grow rapidly. Leyna, now 20 months old, is a healthy, happy, bubbly toddler, and the small scar she received from surgery, has all but disappeared.