We describe a case of giant sacrococcygeal teratoma (SCT) diagnosed at 21 weeks of gestation. Due to the signs of vascular steal and fetal heart failure at 24 weeks of gestation, sclerosis of the nutrient vessel was proposed by a laser diode. The procedure was performed by percutaneous puncture guided by ultrasound on three occasions, at 24 weeks, at 27 and at 30 weeks. There was no immediate side effect after treatment. The devascularisation was partial, due to the peripheral hypervascularisation of the mass. Signs of fetal heart failure normalised after 1 week with decreased tumour growth. Delivery was performed by Caesarean at 34 weeks, 2800 grs, due to premature rupture of the membranes and advanced labour in pelvic presentation. Six hours after birth, tumour excision was performed using a conventional technique, in which SCT with a total weight of 630 grs was completely removed. Minimally invasive surgery with sclerosis of the nutrient vessel seems to improve the perinatal outcome in cases of high-risk fetal SCT. Identification and early treatment can give us a successful outcome.
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