Giant Sacrococcygeal Teratoma in Neonate: A Case Report and Review of Literature

Abstract

Sacrococcygeal teratoma is considered the most common tumor in the neonatal period with a female-to-male ratio of 3–4:1. They are believed to arise early in gestation from the totipotential cells of Hensen’s node and the derived ectoderm, mesoderm, and endoderm. A 2.25 kg cesarean-delivered male, term neonate presented with large nonpulsatile, globular erythematous mass with lobulated surface and variable consistency. Magnetic resonance imaging of the lumbosacral spine showed multilocular cystic and solid lesion with foci of calcification and subtle communication with spinal canal. Histopathological examination showed mature endodermal, ectodermal, and mesenchymal elements such as cartilage, glial tissues, keratin cyst, and glandular elements with focus of primary neuroepithelial and pancreatic elements. Entire tumor was excised. The baby expired secondary to wound infection. Early diagnosis by improving antenatal care with timely surgical intervention and good nursing care improves the outcome.

Giant sacrococcygeal teratoma in an infant: a case report with a literature review

“…It has a favorable prognosis depending on the date of diagnosis, the simplicity of coccygectomy, and the tumor’s risk for malignancy. The female neonate is mainly affected; however, it is unclear why women predominate 2 , 9 . According to the AAPSS, there are four types of SCT based on internal and external tumors.…”

“…The surgery time is essential since postponing is linked to a greater risk of malignancy and recurrence. Without coccyx excision, the recurrence rate reaches 37% 9 , 10 . Due to the above-mentioned risks, in the present case, a coccygectomy was performed on the fifth day after delivery.…”

“…Although the literature has reported excellent survival rates, the mortality rate for masses larger than 10 cm is 18%. Even in patients with an entirely removed coccyx, the probability of recurrence ranges from 11% to 22%, so close follow-up every 3–6 months with physical examinations such as a rectal exam, diagnostic imaging, and AFP are recommended for at least 3 years 9 . In our case, there has been no recurrence after 2 years of follow-up.…”

Ruptured giant sacrococcygeal teratoma

“…[3] The antenatal diagnosis of the tumor with routine ultrasonography is essential to planning an adequate mode of delivery and interventional treatment when needed and to identifying fetuses that are at a higher risk of complications. [4].…”