Early prenatal diagnosis of Jeune syndrome in a low‐risk pregnancy
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the posterior triangle, and the pharynx (Reynolds and Wolinski, 1993). In our case also, BCC is located at the left anterior triangle of the neck. Histopathology findings showed that the BCC is lined by squamous epithelium and more than 90% have abundant sub-epithelial lymphoid tissue. Typically, cyst fluid contains cholesterol crystals and epithelial cells, as in our case. Differential diagnosis of congenital head and neck masses includes congenital cystic hygroma, meningomyelocele, hemangioma, dermoid cyst, laryngocele, thyroglossal duct cyst, thyroid gland mass, teratoma, and BCC (Suchet, 1995). The abnormalities identified were differentiated with respect to their position (at the central midline or anterolateral or lateral to the midline) and ultrasonographic characteristics (solid, cystic, or mixed; calcified or vascular); the relation of the abnormality to the major vessels of the neck and the presence of associated abnormalities (such as polyhydramnios, a fetal tumor, or bone anomalies) could be helpful. The lack of any solid elements or septations can be used to differentiate BCC from teratoma (Suchet, 1995). The diagnosis of BCC should be considered if a well-defined lesion is found anteriorly in the neck. As shown in Figure 1, the surface-rendering mode of 3D ultrasound revealed a cyst with a smooth wall at the left anterior triangle of the neck. The deeper rendering mode of 3D ultrasound further depicted that the inner wall of the cyst is smooth and without any septum. With these characteristics in imaging, 3D ultrasound helped reach the prenatal diagnosis of BCC. Because of the high risk of infection, early surgical excision is recommended (Ribichaud et al., 2000). The prognosis is usually good after surgery. Primary resection of BCC has a reported recurrence rate of only 3% versus 14% for resection of these lesions once they have become infected (Choi and Zalzal, 1995). At delivery, airway obstruction resulting from BCC may cause significant neonatal morbidity and mortality. Therefore, prenatal diagnosis of BCC is of help in lowering morbidity and mortality. In our case, we showed that 3D ultrasound can help in the differential diagnosis between BCC and other neck lesions. To the best of our knowledge, our case may be the first BCC to be illustrated by 3D ultrasound in utero.
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