Fetal Sacrococcygeal Teratoma: A Case Report of a Giant Tumor withan Excellent Outcome

Sacrococcygeal teratoma (SCT) occurs in approximately 1 per 20,000-40,000 births and is the most frequently encountered fetal teratoma, with 75% of cases observed in female fetuses. SCT can be detected on ultrasound as early as the first trimester, presenting as a large mass originating from the sacrococcygeal area, with or without an intrapelvic component. The prenatal course for most fetuses with SCT is generally uneventful, with only a few cases experiencing obstetric and fetal complications. We present the case of a 19-year-old woman who was in good health and had no relevant family or medical history. She was gravida 2 and para 1. During the first trimester scan, an examination revealed a heterogeneous mass in the presacral area with a predominantly multicystic appearance, measuring 12 mm in diameter. At 21+6 weeks of gestation, the Type 2 fetal SCT showed an increase in volume with the size of 49×37×36 mm and contiune to increase in size. The male fetus was delivered by elective Cesarean section at 38 weeks of gestation. The resection of the tumor and coccyx was performed when the newborn was 7 days old. The tumor measured 190×160×100 mm and weighed 1100 g. Pathological examination confirmed the diagnosis of a mature teratoma (Grade 0), and the resection margins were negative. Our case report highlights a fetus with a large and rapidly growing SCT, yet the outcome was excellent.

Perineal wound disruption and postoperative infection following resection of a benign cystic sacrococcygeal teratoma in a neonate in a resource-limited setting: A case report

Case reports highlighting the complications of SCT surgical resection in resource-limited settings particularly sub-Saharan Africa are few. It is imperative to take into account that achieving the desirable cosmetic results may not be possible because of large tumor size and postoperative infection. It is therefore of necessity to consider integration of plastic surgical reconstructive programs into pediatric surgery follow-up programs in resource-limited settings.

Long-Term Outcome of Sacrococcygeal Teratoma: A Controlled Cohort Study of Urinary Tract and Bowel Dysfunction and Predictors of Poor Outcome

OBJECTIVE

To evaluate urinary tract and bowel function in children with sacrococcygeal teratoma, compare the findings with healthy children, and assess predictors of poor outcome.

STUDY DESIGN

This was a controlled cohort study of all patients operated for sacrococcygeal teratoma at a tertiary pediatric surgery center, 2000-2013. Urinary and bowel function were compared with healthy control patients matched for age and sex. Perioperative and histopathologic risk factors were analyzed.

RESULTS

In total, 17 patients with sacrococcygeal teratoma and 85 healthy control patients were included in the study. Patients with sacrococcygeal teratoma more often were reported to have uncontrolled voiding (12% vs 0%, P < .01), difficulty in bladder emptying (24% vs 0%, P < .001), and pyelonephritis (18% vs 1%, P < .05). Constipation was more common in patients with sacrococcygeal teratoma (47 % vs 14%, P < .05), but the overall bowel function score was equal in the 2 groups. Children with large tumors and immature histology were more likely to have a dysfunctional outcome (P < .05).

CONCLUSIONS

Uncontrolled voiding, difficulty in bladder emptying, pyelonephritis, and constipation were more common in patients with sacrococcygeal teratoma than in healthy children. Dysfunctional outcome was more prevalent in children with large and immature teratomas.