Prenatal diagnosis and outcome in sacrococcygeal teratomas: a review of cases between 1992 and 1998

Abstract

A review of sacrococcygeal teratomas diagnosed in the antenatal period in the West Midlands region over a six year interval is reported. The aim of the study was to assess the contribution of ultrasound scanning to the management of cases and to determine the outcome of prenatally diagnosed sacrococcygeal teratomas. A retrospective review of 10 cases was performed to obtain pregnancy details, ultrasound scan data and outcome information. Two fetuses were electively aborted. Perinatal mortality was 62.5% in the remaining cases with all stillbirths and neonatal deaths occurring in babies delivered preterm (at or before 34 weeks' gestation). Marked increase in tumour size (mainly vascular/solid) was observed in five of the fetuses, which was often associated with local compression effects and the development of hydrops. Eight out of 10 cases were delivered vaginally, one following aspiration of the large cystic tumour. Three of the four neonates surviving to surgery underwent successful resection of their benign tumours. As well as guiding prognosis, serial ultrasound scans may also allow the mode of delivery to be planned more effectively. The importance of a multidisciplinary team approach to these difficult cases is emphasized.

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“…The prenatal diagnosis of the sacrococcygeal teratomas can be easily made with conventional two-dimensional ultrasound scan 12 . In the first trimester these neoplasms usually escape the ultrasonographic diagnosis because of their small size 12,13 . The advantages of the three-dimensional ultrasound scan are the definition of the total volume of the neoplasm, its extension to the pelvis and the possible skeletal involvement for a better surgical excision…”

“…In addition, the foetus is at risk of chronic foetal anaemia due to haemorrhage within the tumour 16 . The successful management of sacrococcygeal teratomas depends on the mode of delivery and the classification of the tumour 7,9,13 . Delivery of the foetus through a caesarean section prevents dystocia, tumour rupture and profuse tumoural bleeding 14,15 .…”

Prenatal diagnosis of a huge foetal immature sacrococcygeal teratoma: our experience of a rare case and review of the literature

“…Arteriovenous shunting through the tumour causes the high-output cardiac failure. The causes for the prematurity are usually the uterine distension from the neoplasm and the polyhydramnios, while the intrauterine foetal demise is secondary to the vascular steal syndrome and the increased metabolic demands of a huge neoplasm [7][8][9][13][14][15] . In addition, the foetus is at risk of chronic foetal anaemia due to haemorrhage within the tumour 16 .…”

A case of immature sacrococcygeal teratoma diagnosed by prenatal ultrasonography

“…초음파를 이용한 산전진단과 검사는 예후에 관한 결정적인 정보를 제공할 수 있으나 악성종양과 양성종양을 감별할 수는 없고, 오직 조직검사에 의해서만 감별이 가능하다 [11,12]. 주기적 인 초음파검사는 예후를 시사하는 정보제공의 역할뿐만 아니라 분만방 법과 시기를 결정하기 위해 중요하다 [13,14]. …”