Long-term functional outcome of sacrococcygeal teratoma after resection in neonates and infants: a single-center experience

Masahata, Kazunori; Ichikawa, Chihiro; Makino, Katsutoshi; Abe, Takatoshi; Kim, Kiyokazu; Yamamichi, Taku; Tayama, Ai; Soh, Hideki; Usui, Noriaki

doi:10.1007/s00383-020-04752-7

Cited by 12 publications

(9 citation statements)

References 18 publications

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“…In our study, 25% of index patients were diagnosed antenatally. Two recent studies conducted in the UK and Japan declared that antenatal diagnosis was established in 44% and 41.4% of their patients, respectively [ 22 , 23 ]. Such a difference mandates increasing the awareness of antenatal diagnosis of SCT among obstetricians in our country.…”

Section: Discussionmentioning

confidence: 99%

Management strategy and outcomes of sacrococcygeal teratoma — an Egyptian multicenter experience

Elgendy,

AbouZeid,

El-Debeiky

et al. 2023

World J Surg Onc

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Objectives Nationwide criteria regarding patients with sacrococcygeal teratoma (SCT) are still lacking in Egypt. We aimed to present a multicenter study regarding the management and outcomes of this tumor to evaluate our national treatment strategy. Methods A retrospective analysis including all patients with SCT who were managed at four major Egyptian centers between 2013 and 2023. Clinical data, surgical approaches, and short- and long-term outcomes were discussed. Results The study included 95 patients (74 were females). Antenatal diagnosis was reported in 25% of patients. Seventy-one patients (74.7%) were classified as Altman type I/II. Surgery was performed via a perineal approach in 75 patients, whereas the remaining 20 underwent a combined abdominoperineal approach. Vertical elliptical incision with midline closure was conducted in 51.5% of patients, followed by classic or modified chevron incisions. Benign mature teratoma was detected in 82% of patients. At a median follow-up of 57 months, eight patients (8.5%) had relapsed. The 5-year overall survival (OS) and event-free survival (EFS) of all patients were 94% and 91%, respectively. In the after-care monitoring, 19 patients (20%) had urinary or bowel dysfunctions. Nine of them were managed using medications. Clean intermittent catheterization was practiced in another five patients. The remaining five underwent further surgical interventions. Conclusion Favorable outcomes were achieved in our country during the last decade. Diverse perineal incisions were performed for resection, and vertical elliptical with midline closure was the commonest. During follow-up, 20% of patients developed urological or bowel dysfunctions that required medical and surgical treatment modalities to improve their quality of life.

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Section: Discussionmentioning

confidence: 99%

Management strategy and outcomes of sacrococcygeal teratoma — an Egyptian multicenter experience

Elgendy,

AbouZeid,

El-Debeiky

et al. 2023

World J Surg Onc

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“…However, it is important to note that our data may underestimate the quality-of-life impact of bowel and bladder problems for our patient group as data were gathered from clinical notes and not from formal patient questionnaires as was performed in other studies. [7][8][9]…”

Section: Bowel and Bladder Controlmentioning

confidence: 99%

The Irish Experience with Sacrococcygeal Teratomas: Are Type IV Lesions More Common than We Think?

Kane,

Mortell,

Gillick

et al. 2023

Eur J Pediatr Surg

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Title The Irish experience with Sacrococcygeal Teratomas- are type IV lesions more common than we think? Introduction Sacrococcygeal Teratomas (SCT) are rare tumours occurring in approximately 1 in 35,000 to 40,000 live births. The Altman classification is used to describe SCTs. There are four types, with type 1 predominantly external through to type IV which is a presacral, completely internal mass. As far as the authors are aware, this is the first study to focus on Type IV SCT lesions. Materials and Methods Using ICD-10-AM codes, we identified all patients in the Republic of Ireland with a diagnosis of Sacrococcygeal Teratoma from 2004-2020. The following information was obtained for each patient; gender, time of diagnosis, clinical presentation, method of diagnosis, Altman classification, biomarkers, age at operation, surgical technique, pathology, recurrence, age at most recent follow-up. Results There were 29 patients in total; 23 Females (79%) and 6 males (21%). 16 (55%) were diagnosed antenatally, 4 (14%) at <1 month, 4 (14%) <1 year, 3 (10%) age 2-4 years and 2(7%) were aged 5-12 years. 22 (76%) were Mature Teratomas, 2 (7%) immature teratomas and 5 (17%) were Malignant tumours. There were 6 (21%) Type I lesions, 9 (30%) Type II, 6 (21%) Type III and 8 (28%) Type IV lesions. Conclusions In Altman’s original 1974 study, type IV lesions were present in 10% of cases. As a result, this is the most frequently quoted figure. Type IV lesions were present in 28% of cases in our study. We propose that type IV lesions may be more common than the current literature suggests and consequently a higher index of suspicion of their presence should be entertained.

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“…Approximately 25–50% of SCTs are diagnosed in utero before birth (i.e., true congenital neoplasms) during routine ultrasonographic surveillance ( Fig. 1 ) [ 10 , 24 ]. In utero diagnosis of SCT warrants vigilant fetal monitoring because of the higher risks of polyhydroamniosis, fetal hydrops, or placentomegaly, which may lead to premature delivery or fetal demise.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Large type II–IV SCT can exert mass effects on intrapelvic organs and present with severe problems such as constipation, fecal incontinence, neurogenic bladder, and urinary incontinence [ 30 ]. Large type III SCT often requires extensive abdomino-sacral resection and carries high risks of a poor functional outcome [ 24 ].…”

Section: Clinical Featuresmentioning

confidence: 99%

Sacrococcygeal Teratoma : A Tumor at the Center of Embryogenesis

Phi

2021

J Korean Neurosurg Soc

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Sacrococcygeal teratoma (SCT) is an extragonadal germ cell tumor (GCT) that develops in the fetal and neonatal periods. SCT is a type I GCT in which only teratoma and yolk sac tumors arise from extragonadal sites. SCT is the most common type I GCT and is believed to originate through epigenetic reprogramming of early primordial germ cells migrating from the yolk sac to the gonadal ridges. Fetal SCT diagnosed in utero presents many obstetrical problems. For high-risk fetuses, fetal interventions (devascularization and debulking) are under development. Most patients with SCT are operated on after birth. Complete surgical resection is the key for tumor control, and the anatomical location of the tumor determines the surgical approaches. Incomplete resection and malignant histology are risk factors for recurrence. Approximately 10-15% of patients have a tumor recurrence, which is frequently of malignant histology. Long-term surveillance with monitoring of serum alpha fetoprotein and magnetic resonance imaging is required. Survivors of SCT may suffer anorectal, urological, and sexual sequelae later in their life, and comprehensive evaluation and care are required.

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Long-term functional outcome of sacrococcygeal teratoma after resection in neonates and infants: a single-center experience

Cited by 12 publications

References 18 publications

Management strategy and outcomes of sacrococcygeal teratoma — an Egyptian multicenter experience

Management strategy and outcomes of sacrococcygeal teratoma — an Egyptian multicenter experience

The Irish Experience with Sacrococcygeal Teratomas: Are Type IV Lesions More Common than We Think?

Sacrococcygeal Teratoma : A Tumor at the Center of Embryogenesis

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