07:59am Wednesday 23 October 2019

World’s First In Utero Surgery to Remove Tumor Saves Unborn Child’s Life

Just 20 months old, Leyna Mykaella Gonzalez sat with Ruben Quintero, M.D., professor of obstetrics and gynecology, and Eftichia Kontopoulos, M.D., assistant professor of obstetrics and gynecology, who detailed the case recently documented by the American Journal of Obstetrics and Gynecology as the world’s first successful removal of a fetal oral teratoma.

Midway through her second pregnancy, Tammy Gonzalez went for a routine ultrasound and saw an unnerving image: Her unborn daughter seemed to be blowing a bubble from her mouth. The ‘bubble’ was actually an oral teratoma, a large tumor growing from the fetus’s mouth. Doctors told Tammy there was little chance her daughter would survive birth – and if she did, she would require an immediate tracheotomy to breathe and have to endure many surgeries thereafter.

Devastated, Tammy and her husband Alain sought out Quintero, director of the UM/Jackson Fetal Therapy Center and a pioneer in fetal medicine who treats many birth defects and high-risk conditions in babies still in the womb.

“The concern with these tumors is they can grow very rapidly,” said Quintero. “They can cause bleeding, which can cause the death of the baby.”

Quintero explained the risks to the Gonzalezes, and in May 2010 Quintero and Kontopoulos operated on Leyna in utero. Using an endoscope guided by ultrasound, their team removed the mass with a laser and cleared the baby’s mouth. Tammy remained awake and only under local anesthesia for the procedure, which lasted just over an hour.

Five months later, on October 1, 2010, Leyna Mykaella Gonzalez was born healthy and just an ounce over 8 pounds, a tiny scar near the corner of her mouth the only evidence of her surgery.

“We think the world of the doctors,” Tammy Gonzalez said. “They are our saviors. Without them, she wouldn’t be here.”

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