Jerusalem Post

ByLEO FEIERBERG BETTER

A medical team at Rabin Medical Center removed the largest-ever facial tumor found on a fetus, the hospital announced in a statement last week.
Discovered at 33 weeks of pregnancy, Prof. Yinon Gilboa, Director of the Gynecologic and Obstetric Ultrasound Unit at the Women’s Hospital in Rabin Medical Center, was surprised to see the tumor, described as “the largest of its kind and location ever-described in medical literature” protruding from the fetus’s mouth. 
Attached to the upper jaw, the tumor separated the lips of the fetus. Additionally, the benign tumor contained a significant blood supply from the jaw. According to the hospital, these symptoms resemble Epulis, a rare diagnosis which affects one in 200,000 births and isn’t usually detected during pregnancy. 

Outlining possible complications stemming from Epulis in an infant, Dr. Gilboa explained that in cases like these, it’s imperative to “determine the location, assess whether the tumor is benign or malignant, check whether adjacent bones are involved, evaluate cosmetic impact and determine if there is any risk of airway obstruction.”

The medical team conducted an MRI and the hospital convened a meeting with “the oral and maxillofacial specialists, the neonatal intensive care unit, and the high-risk pregnancy team.”

As a result, the team decided to continue the monitoring until delivery, making sure that no airway obstruction developed. 

Because of concerns of complications in a normal birth, the medical team decided to perform a cesarean section, performed by Dr. Yuval Yaniv on November 13. Following the successful cesarean section, the team transferred the newborn to a room where another team administered anesthesia nasally.
The hospital tasked its Deputy Director of the Department of Oral and Maxillofacial Surgery, Dr. Gal Avishai with the planning of the operation which followed the delivery.
The dangers of the Israeli medical team's tumor surgery
Explaining the dangers of the surgical operation, Dr. Avishai said that “[the] primary surgical challenge was to remove a tumor measuring about six centimeters when the baby’s head is only about eight centimeters, while minimizing bleeding.”
“Infants have a very small blood volume and arterial bleeding from such a tumor can become life-threatening very quickly. Prenatal imaging showed large blood vessels running along the tumor. The surgery required layered ligation of the tumor stalk and meticulous blood control. At the end, the area was sutured and the baby was transferred to the NICU.”
Checkups following the surgery showed “normal healing” and the baby will continue to have follow-ups until her teeth come in, the hospital said.