Factors associated with recurrence and metastasis in sacrococcygeal teratoma

Abstract

This national study showed that SCT recurred in 11 per cent of the children within 3 years of operation. Risk factors were immature and malignant histology, or incomplete resection. Mature teratoma has the biological capability to become malignant.

Currarino syndrome and spinal dysraphism

“…In a series of 17 children with presacral masses from a single center, 11 of whom had Currarino syndrome, 3 patients, including 1 with Currarino syndrome, had a malignant tumor. 1 A retrospective review of 173 children with sacrococcygeal teratoma treated in the Netherlands between 1970 and 2003 demonstrated mature histology in 64.3%, immature histology in 19.3%, and malignant histology in 12.9%; 8 however, the association with Currarino syndrome was not described. Given these findings, early resection of presacral masses in children is recommended, but it is unclear whether the risk of malignancy with Currarino syndrome-associated teratomas differs from that with sporadic sacrococcygeal teratomas.…”

“…Given these findings, early resection of presacral masses in children is recommended, but it is unclear whether the risk of malignancy with Currarino syndrome-associated teratomas differs from that with sporadic sacrococcygeal teratomas. 1,8 A presacral anterior meningocele was identified in 58 (43%) of 135 patients, and these occurred together with a presacral nondysraphic tumor in 47% of cases. In studies of spinal cord anomalies, 66 (60%) of 110 patients had at least one spinal cord anomaly consisting of an anterior meningocele, spinal lipoma, diastematomyelia, low-lying conus, or syrinx.…”

Long-term outcomes of surgery for malignant sacrococcygeal teratoma: 20-year experience of a regional UK centre

“…The authors reported that cases diagnosed after the neonatal period were more likely to develop malignant teratoma [9]. A long-term study from the Netherlands found that incomplete excision of the tumour was a risk factor in recurrence, whilst size and Altman classification were not risk factors [10]. In another study from Belgium, recurrence was associated with spillage of tumour and incomplete removal of the coccyx, but spillage of cyst fluid did not cause recurrence [11].…”

Sacrococcygeal Teratoma

“…Derikx et al [38] and De Backer et al [39] studied the factors responsible for tumor recurrence in a cohort of 173 and 70 children respectively. Incomplete excision [38], failure to excise coccyx [39] and malignant or immature histology have emerged as risk factors of tumor recurrence [38,39]. Microscopic residue of mature or immature teratoma at the resection margin was rarely associated with local recurrences; however, presence of yolk sac tumor (YST) component was an exception to this rule [39].…”

“…In case of cystic teratomas spillage of solid components rather than the cyst fluid was responsible for recurrences [39]. According to Derikx et al [38] tumor size, Altman type and age at diagnosis are not associated with recurrence. In this context, Athena is reminded of a previous paper wherein Bilik et al [40] have showed that a large tumor may possibly have imperceptibly tiny foci of malignant cells; missing these tiny foci during histological sectioning may erroneously label the tumor as benign.…”