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

Abstract

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

Perineal wound disruption and postoperative infection following resection of a benign cystic sacrococcygeal teratoma in a neonate in a resource‐limited setting: A case report

“…Like any other surgical procedure, complications arising from surgical resection can either be short‐term—postoperative wound infection and perineal wound disruption (Figure ) as was in our patient, rectal injury, diarrhea, tumor rupture, hemorrhage, septicemia, or be long‐term—urethral obstruction, midurethral necrosis, anorectal dysfunction, fecal incontinence, severe chronic constipation, neurourological dysfunction of the lower urinary tract, bladder sphincter dysfunction, vesicoureteral reflux, urinary incontinence, neurogenic voiding dysfunction, mixed neurogenic damage, abnormal bladder, and urethral functions diminished sexual function in females, deformity, unpleasant scars, and tumor recurrence …”

Early Outcomes of the Surgical Treatment of Sacrococcygeal Tumors in a Tertiary Level Government Hospital

“…Out of the 29 patients, 24.14% underwent surgery at less than one month of age and 41.38% of them were operated on at more than one year of age. The delay in the timing of consult and surgery may possibly be related to the lower socio-economic status, lack of awareness, and the scarcity of tertiary hospitals in the provinces as mentioned in a study by Kundal et al 10 The diagnostic evaluation of SCT involves imaging studies and serum tumor markers. CT scan was the most common imaging tool utilized (37.93%) in our study, followed by ultrasound (27.59%) and only 6.9% patients underwent MRI.…”

“…Diagnostic tests for SCT include abdominopelvic ultrasound, serum alpha feto protein (AFP) and xrays. 3,10 A contrast enhanced abdominopelvic CT scan is warranted in some cases for better preoperative planning, because of the ability to describe the tumor's location under the Altman classification. The Altman classification of SCT subdivides tumors based on the anatomic location and pelvic extension: Type I describes tumors that are predominantly external with minimal pre-sacral component; Type II are tumors that present externally but with significant intrapelvic extension; masses that are predominantly pelvic and extending into the abdomen but are still appreciable externally are classified as Type III; and Type IV masses are pre-sacral with no external component.…”

“…Massive intraoperative hemorrhage, surgical site infection, urinary retention, urinary tract infection, and fecal soiling are among the immediate complications noted with wound infection as being the most common. 3,4,9,10 There is currently no published literature on sacrococcygeal tumors in the Philippines. The objective of the study is to look at the clinical experience with sacrococcygeal tumors in the PGH.…”

Sacro-coccygeal Teratoma in a Child of 6 Months: A Case Report

“…The average age of discovery of this pathology were different ranging from 4 days to 11 months with extremes ranging from 1 day to 5 years. Rescola et al found an average of 11 months (extremes 1.5 days -34 months), Kundal et al -4 days (1 day -4 years) [9,10]. Rattan et al discored the age ranged from newborn to 13 years.…”