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

Khalil, Basem A.; Aziz, Asher; Kapur, Pierina; Humphrey, G. M. E.; Morabito, Antonino; Bruce, J.

doi:10.1007/s00383-009-2329-7

Cited by 15 publications

(5 citation statements)

References 14 publications

(14 reference statements)

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“…This lack of surveillance may be due to some published series minimizing the risk of urologic co‐morbidity. For example, Khalil et al reported that only 1 of 12 (8.3%) patients suffered any urologic complications. However, this study, as with many others, lacks any description of how the authors assessed urologic co‐morbidity.…”

Section: Discussionmentioning

confidence: 99%

Urologic co‐morbidities associated with sacrococcygeal teratoma and a rational plan for urologic surveillance

Cost

Geller

et al. 2013

Pediatric Blood & Cancer

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Section: Discussionmentioning

confidence: 99%

Urologic co‐morbidities associated with sacrococcygeal teratoma and a rational plan for urologic surveillance

Cost

Geller

et al. 2013

Pediatric Blood & Cancer

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“…Postoperative monitoring is also necessary ( 19 ), as the possibilities of recurrence and malignant transformation exist. The probability of malignant transformation reportedly increases with age ( 20 ); as such, regular CT and physical examinations should be performed to detect any progression in residual teratoma tissue over the course of the patient's life ( 20 ). To that end, alpha-fetoprotein is a sensitive serum marker that can be used to screen for teratoma recurrence, as well as the severity thereof ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Resection of a massive primary sacrococcygeal mature teratoma in an adult using 3-dimensional reconstruction and mixed reality technology

Zhang

Liu

et al. 2022

Front. Surg.

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IntroductionTeratomas are rare neoplasms that arise from pluripotent germ cells. Sacrococcygeal teratomas are often diagnosed in infants but are rare in adults; a mature teratoma can contain hair, teeth, bony tissue, and other mature tissue types. Herein, we report for the first time a patient with a teratoma containing intact bones that formed a pseudoarthrosis.Case reportA 49-year-old woman was admitted to hospital after a massive life-long sciatic tumor had begun to grow larger over the past year. A 16 cm × 25 cm solid mass with a clear boundary was palpable in the sacrococcygeal region. Radiography, computed tomography, and magnetic resonance imaging indicated a sacrococcygeal teratoma, although blood alpha-fetoprotein levels were normal. The teratoma was completely excised using 3-dimensional reconstruction mixed reality (MR) technology with no notable complications. Postoperative pathological examination of the excised lesion confirmed a mature teratoma. Interestingly, two intact irregular bones that formed a pseudoarthrosis were isolated; one was 11 cm and the other 6 cm. The patient is currently healthy and has experienced no recurrences.ConclusionSacrococcygeal teratomas are rare, especially in adults, and often comprised lots of components, such as fat, bony tissue. However, it's first reported that formation of pseudoarthrosis in this case so far. It is difficult for surgeons to achieve complete excision without complications owing to the complex anatomic structure of the sacrum. The 3-dimensional reconstruction and mixed reality (MR) technology based on computed tomography can provide spatial visualization, which allows surgeons to examine the teratoma at different angles preoperatively. Combining 3-dimensional reconstruction and mixed reality (MR) technology in this case facilitated complete resection and prevented recurrence.

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“…A per-rectal examination was performed to rule out a fecaloma, and a mass posterior to rectum was identified. A literature search on PubMed and Google unearthed several reports wherein sacrococcygeal teratomas have been mistaken for lesions such as hemangiomas,[11] meningomyeloceles,[1213] vertebral disc prolapse,[12] abscesses,[1214] fecal or perianal fistula,[12] cloaca, and fistula-in-ano or inguinal lymphadenitis. [12] The vice-versa is also true with lesions such as extraspinal sacrococcygeal ependymoma,[15] genitourinary plexiform neurofibroma[16] and congenital infantile fibrosarcoma[17] masquerading as sacrococcygeal teratoma.…”

Section: Discussionmentioning

confidence: 99%

Sacrococcygeal teratoma: Clinical characteristics, management, and long-term outcomes in a prospective study from a Tertiary Care Center

Yadav

Acharya

Bagga

et al. 2020

J Indian Assoc Pediatr Surg

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Introduction:The study focuses on the clinical presentation, management, and outcomes (both short term and long term) in patients with sacrococcygeal teratoma managed over a decade in a tertiary care center.Materials and Methods:This is a prospective study on children with sacrococcygeal teratoma over 12 years data collected included antenatal diagnosis, mode of delivery, age at diagnosis, clinical presentation, physical extent of mass (including Altman classification), levels of alpha-fetoprotein, surgical approach, histopathology, clinical outcome, recurrence and long-term results including bladder-bowel dysfunction and neurological impairment. Functional results were evaluated clinically and radiologically.Results:During the study, 41 patients (male to female ratio of 1:3.1) with a median age of 36 days (1 day–11.6 years) with sacrococcygeal teratoma were managed at our center. The mean follow-up duration was 54 months (range 19–110 months). Nearly, two-thirds of the tumors were either Altman Type 1 or 2. Yolk sac tumor was present in 8 (19.5%) patients, while the rest has either mature or immature teratoma. Tumors were removed through a posterior sagittal or a chevron incision. In seven patients, abdominosacral approach was necessary. Eight patients with malignant disease received chemotherapy (neoadjuvant in 5). Overall survival was 95% at a mean follow-up of 54 months. Among the late complications, three patients had a local recurrence of tumor, and urinary dribbling was present in three patients.Conclusions:Teratomas are the most common germ cell tumors of the sacrococcygeal region. Most of the tumors are benign, and the incidence of malignancy increases with age. The evaluation of malignancy is, therefore, necessary in these children. Excellent survival of 95% was achieved in this series. Morbidity due to associated malformation, disease recurrence, and treatment may persist in these patients; hence, proper follow-up is needed.

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

Abstract: Surgery for malignant sacrococcygeal teratoma is safe and has a low complication rate. The long-term outcomes are favourable with minimal side effects.

Cited by 15 publications

References 14 publications

Urologic co‐morbidities associated with sacrococcygeal teratoma and a rational plan for urologic surveillance

Urologic co‐morbidities associated with sacrococcygeal teratoma and a rational plan for urologic surveillance

Case report: Resection of a massive primary sacrococcygeal mature teratoma in an adult using 3-dimensional reconstruction and mixed reality technology

Sacrococcygeal teratoma: Clinical characteristics, management, and long-term outcomes in a prospective study from a Tertiary Care Center

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