Sacrococcygeal teratoma: control of catastrophic haemorrhage

Collins, Katherine; Friend, Jikol; Kikiros, Colin; Khosa, Japinder; Barker, Andrew; Gera, Parshotam

doi:10.1111/ans.15022

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…Hemorrhagic complications are the most common cause of death during surgical resection in the neonatal period. 25 , 26 Disseminated intravascular coagulation developed in 1 of our cases after surgery. Another complication is injuries to the colon, ureter, and bladder during surgery, particularly in type 4 cases.…”

Section: Discussionmentioning

confidence: 74%

Clinicopathological Evaluation of Childhood Sacrococcygeal Germ Cell Tumors: A Single-Center Experience

Hasbay¹,

Canpolat²,

Aktekin³

et al. 2022

Turk Arch Pediatrics

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Objective We aimed to evaluate the cases of sacrococcygeal germ cell tumors diagnosed in our hospital between 2006 and June 2021. Materials and Methods We evaluated 38 sacrococcygeal germ cell tumors cases in our series in terms of age, sex, clinical complaints, localization, macroscopy, tumor size, histopathological diagnosis, surgical, postoperative complications, treatment, recurrence, and prognosis. Results The cases ranged from 1 day to 16 years of age; 14 cases were diagnosed with routine ultrasonographic examination during prenatal period while the rest of the cases most frequently presented with complaints of constipation. In terms of localization, 6 cases were type 1, 11 cases were type 2, 6 cases were type 3, and 15 cases were type 4. In the pathological evaluation, 25 cases were mature teratoma, 8 cases were immature teratoma, and 5 cases were pure yolk-sac tumor. In terms of complications, temporary colostomy was performed as a result of rupture during birth in 2 cases, disseminated intravascular coagulation at birth in 1 case, and colon injury in 2 cases. There was a recurrence in 2 of our cases. Thirty-seven of our cases were alive and 1 died. Alpha-fetoprotein level was high in 28 of our cases. Conclusion In our series, type 4 cases were observed more frequently, contrary to the literature. We recommend to use a routine ultrasonography to patients who come to the clinic with complaints of constipation and inability to urinate and if a mass is detected, asking for alpha-fetoprotein for further follow-up. Sacrococcygeal germ cell tumors are ultimately a disease that can be successfully treated with multidisciplinary approach, accurate diagnosis in the antenatal and postnatal period, appropriate surgical intervention, and regular follow-up.

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Section: Discussionmentioning

confidence: 74%

Clinicopathological Evaluation of Childhood Sacrococcygeal Germ Cell Tumors: A Single-Center Experience

Hasbay¹,

Canpolat²,

Aktekin³

et al. 2022

Turk Arch Pediatrics

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“…The main indications of endoscopic laser ablation of superficial vessels in sacrococcygeal teratomas are rapid growth rate, high vascularity in solid tumors, polyhydramnios, cardiac decompensation, fetal hydrops and haemorrhage 19 and the most common procedure complication is preterm birth below 32 weeks of gestation due to preterm premature rupture of membrane as a possible result of fetal laser surgical therapy 6 and also deterioration of fetal cardiac function and hydrops. Another possible procedure is intrauterine intervention, in the form of open fetal surgery 13 or percutaneous intratumor ablation by laser or radiofrequency 20 .…”

Section: Discussionmentioning

confidence: 99%

“…The teratoma is also related to other fetal abnormalities, the most common of which are in the genitourinary tract and may include hydronephrosis, renal dysplasia, urethral atresia, urinary ascites, and hydrocolpos. Cesarean section is the best delivery method in cases of large tumors in order to avoid complications such as dystocia, tumor hemorrhage 19 , and tumor avulsion. Coccyx involvement is frequent, and its resection must be performed, even in benign cases 12 .…”

Section: Discussionmentioning

confidence: 99%

Gestational Diagnosis and Fetal and Neonatal Surgery of Sacrococcygeal Teratoma

Paz¹,

Reis²,

Costa³

et al. 2021

Relatos Casos Cir.

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Introdução: Os teratomas sacrococcígeos (TS) são os tumores congênitos de células germinativas mais comuns, embora raros, com incidência de 1/40.000 nascidos vivos. Descrevemos o diagnóstico intra-uterino de TS por ultrassonografia e tratamento cirúrgico pré e pós-parto durante a epidemia de COVID-19. Relato do caso: Paciente G2P1A0, 16 semanas de gestação, a presença de tumor sólido, de textura heterogênea, vascularizado localizado na região sacrococcígea foi detectado por Doppler colorido no início da epidemia de Covid-19. A paciente apresentou sinais clínicos de amniorrexe prematura com 31 semanas de gestação e foi internada para acompanhamento clínico e com parto programado para 34 semanas de gestação. Recémnascido do sexo feminino, com 3.285 gramas com 990 gramas de tumor sacrococcígeo, foi encaminhado à unidade de terapia intensiva neonatal. O tumor foi ressecado três dias após o nascimento. Discussão: A região sacrococcígea é a localização mais comum de teratomas em crianças. A ultrassonografia tem papel fundamental no diagnóstico prénatal precoce. Além disso, a terapia fetal pode reduzir os resultados perinatais ruins como a hidropisia fetal devido à ablação dos vasos sanguíneos. Conclusão: A ressecção completa do tumor associada à retirada do cóccix é o principal objetivo no tratamento curativo do teratoma, independentemente do seu tipo histológico. O diagnóstico e o tratamento devem ser realizados o mais cedo possível para evitar uma possível transformação maligna.

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