Management and outcome in prenatally diagnosed sacrococcygeal teratomas

Okada, Tadao; Sasaki, Fumio; Cho, Kazutoshi; Honda, Shouhei; Naito, Shigeo; Hirokata, Gentarou; Todo, Satoru

doi:10.1111/j.1442-200x.2008.02703.x

Cited by 26 publications

(25 citation statements)

References 28 publications

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“…Although computed tomography and Magne c resonance imaging are considered be er imaging modali es, as they give be er tumour characteriza on and its rela onship to adjacent structures. Current management strategy in the western world is antenatal diagnosis with a planned caesarean delivery and immediate excision of the tumour 17,18 .…”

Section: Discussionmentioning

confidence: 99%

Sacrococcygeal Teratoma: Experience with 36 Patients in a Teritiary Care Hospital

Kundal

Jadhav

Gupta

et al. 2015

J. Nepal Paedtr. Soc.

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Introduction: Sacrococcygeal teratomas (SCT) are the most common solid tumours in the neonatal period, originate from embryonic totipotent cells. Most of them are benign however some that present later in life and have major intra-pelvic component have greater malignant potential. Complete surgical excision provides an excellent prognosis. The aim of this study was to describe the clinical profile, age of presentation, sex distribution, diagnostic evaluation and management of children with a histological confirmed diagnosis of sacrococcygeal teratoma.Material and Methods: Patients with histological diagnosis of sacrococcygeal teratoma during a period from January 2011 to December 2012 were included in this retrospective study. Data collected included age of presentation, sex distribution, symptoms, associated anomalies, diagnostic evaluation, operative approach technique employed, tumour histology, operative complications and outcome.Results: Thirty six patients with diagnosis of sacrococcygeal teratoma were included in the study. Of these children, 58.33% were females and 41.66% were males. The median age at presentation was four days. 69.44% of patients presented during the neonatal period. 77.77% of patients presented with sacrococcygeal mass followed by lower abdominal mass in 11.11%. The tumour was resected by sacral approach in 27 patients and abdomino sacral approach in nine patients. Tumour was resectable in 34 patients and two had incomplete resection. Follow up duration varied from six months to 24 months.Conclusion: Sacrococcygeal teratomas represent a group of benign and malignant lesions of children. Neonates present with benign disease and aggressive lesions are seen as age progresses. Overall survival of SCT is high.J Nepal Paediatr Soc 2015;35(1):89-93

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Section: Discussionmentioning

confidence: 99%

Sacrococcygeal Teratoma: Experience with 36 Patients in a Teritiary Care Hospital

Kundal

Jadhav

Gupta

et al. 2015

J. Nepal Paedtr. Soc.

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“…[6][7][8][9][10][11][12][13][14][15][16] In contrast, as risk factors in children, heart failure and fetal edema are related to mortality. 17 Recommendation: For tumor lesions outside the pelvis, it is reasonable to consider cesarean section depending on the size thereof in order to avoid tumor rupture, tumor hemorrhaging and delivery difficulty. While there are no reports comparing cesarean delivery and vaginal delivery with respect to vital prognosis, several studies have reported problems with vaginal delivery due to SCT.…”

Section: Guideline Formulation Methodsmentioning

confidence: 99%

Japanese clinical practice guidelines for sacrococcygeal teratoma, 2017

Fumino

Tajiri

Usui

et al. 2019

Pediatrics International

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Background Sacrococcygeal teratoma (SCT) is the most common extragonadal germ cell tumor in neonates and infants. Although most cases of infantile SCT are benign tumors by nature, some develop into extremely large lesions, leading to massive bleeding, high‐output heart failure, disseminated intravascular coagulation, and even fatal outcomes during the neonatal period. In addition, some patients may present with tumor recurrence, malignant transformation, long‐term sequelae (including bladder and bowel dysfunction) and lower leg palsy during the long‐term follow up. SCT, however, is very rare, and there are few opportunities to encounter this disease, therefore general physicians without expert credentials currently lack information relevant to clinical practice. For this reason, the research project committee has compiled guidelines concerning SCT. Methods The purpose of these guidelines was to share information concerning the treatment and follow up of infantile SCT. The guidelines were developed using the methodologies in the Medical Information Network Distribution System. A comprehensive search of the English‐ and Japanese‐language articles in PubMed and Ichu‐Shi Web identified only case reports or case series, and the recommendations were developed through a process of informal consensus. Results The clinical questions addressed the risk factors, the efficacy of cesarean section, the initial devascularization of tumor feeding vessels, interventional radiology, recommended clinical studies for follow up and possible long‐term complications. Conclusions These are the first guidelines for SCT to be established in Japan, and they may have huge clinical value and significance in terms of developing therapeutic strategies and follow up, potentially contributing to the improvement of the prognosis and quality of life of SCT patients.

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“…The antenatal course is usually uncomplicated, but highly vascular or rapidly growing tumours can cause high output cardiac failure, anaemia and hydrops. These are poor prognostic features [110]. Without cardiac compromise or hydrops, 88% survival is quoted [111].…”

Section: Sacrococcygeal Teratomamentioning

confidence: 99%

Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery

Shaw

Haar

Rivens

et al. 2014

J. R. Soc. Interface.

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ReviewCite this article: Shaw CJ, ter Haar GR, Rivens IH, Giussani DA, Lees CC. 2014 Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery. J. R. Soc. High-intensity focused ultrasound (HIFU) is a non-invasive technology, which can be used occlude blood vessels in the body. Both the theory underlying and practical process of blood vessel occlusion are still under development and relatively sparse in vivo experimental and therapeutic data exist. HIFU would however provide an alternative to surgery, particularly in circumstances where serious complications inherent to surgery outweigh the potential benefits. Accordingly, the HIFU technique would be of particular utility for fetal and placental interventions, where open or endoscopic surgery is fraught with difficulty and likelihood of complications including premature delivery. This assumes that HIFU could be shown to safely and effectively occlude blood vessels in utero. To understand these mechanisms more fully, we present a review of relevant cross-specialty literature on the topic of vascular HIFU and suggest an integrative mechanism taking into account clinical, physical and engineering considerations through which HIFU may produce vascular occlusion. This model may aid in the design of HIFU protocols to further develop this area, and might be adapted to provide a non-invasive therapy for conditions in fetal medicine where vascular occlusion is beneficial.

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Management and outcome in prenatally diagnosed sacrococcygeal teratomas

Cited by 26 publications

References 28 publications

Sacrococcygeal Teratoma: Experience with 36 Patients in a Teritiary Care Hospital

Sacrococcygeal Teratoma: Experience with 36 Patients in a Teritiary Care Hospital

Japanese clinical practice guidelines for sacrococcygeal teratoma, 2017

Pathophysiological mechanisms of high-intensity focused ultrasound-mediated vascular occlusion and relevance to non-invasive fetal surgery

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