Sacrococcygeal Teratoma

Christina M Theodorou, M.D., Adesola Akinkuotu, MD, Corey W. Iqbal, MD, Richard D Glick, MD, Charles V. Coren, MD, Melvin S Dassinger, MD, Brad Feltis, MD, PhD
Sacrococcygeal Teratoma is a topic covered in the Pediatric Surgery NaT.

To view the entire topic, please or .

APSA Pediatric Surgery Library combines Pediatric Surgery Not a Textbook (NaT) with APSA ExPERT, a powerful platform for earning MOC CME credits -- all powered by Unbound Medicine. Explore these free sample topics:

-- The first section of this topic is shown below --

Introduction

Sacrococcygeal teratoma (SCT) is an uncommon tumor seen in the newborn occurring in 1 per 35,000 to 40,000 live births. The diagnosis is frequently made prenatally, although a delayed presentation, which adversely impacts prognosis, can be seen in patients with intra-abdominal lesions.

Multiple factors make the management of SCT challenging for the pediatric surgeon. SCTs are often highly vascular large lesions that arise from the coccyx. The vascularity of the lesions can lead to high output cardiac failure. Fetal hydrops results if this occurs in the prenatal period. If left untreated, this almost always results in fetal demise [1]. Postnatally, the vascularity of the tumor can lead to high output cardiac failure in the neonate, with hemodynamic instability which necessitates emergent resection prior to advanced imaging. The lesions are large and abut the anus and rectum making surgical resection difficult. Lifelong difficulty with voiding and defecation can result.

Complete resection is necessary, given their malignant potential. SCTs that extend into the abdomen are difficult to completely resect and sometimes require an approach from both the sacrum and abdomen [2].

content in this topic is referenced in SCORE Teratoma overview

-- To view the remaining sections of this topic, please or --

Introduction

Sacrococcygeal teratoma (SCT) is an uncommon tumor seen in the newborn occurring in 1 per 35,000 to 40,000 live births. The diagnosis is frequently made prenatally, although a delayed presentation, which adversely impacts prognosis, can be seen in patients with intra-abdominal lesions.

Multiple factors make the management of SCT challenging for the pediatric surgeon. SCTs are often highly vascular large lesions that arise from the coccyx. The vascularity of the lesions can lead to high output cardiac failure. Fetal hydrops results if this occurs in the prenatal period. If left untreated, this almost always results in fetal demise [1]. Postnatally, the vascularity of the tumor can lead to high output cardiac failure in the neonate, with hemodynamic instability which necessitates emergent resection prior to advanced imaging. The lesions are large and abut the anus and rectum making surgical resection difficult. Lifelong difficulty with voiding and defecation can result.

Complete resection is necessary, given their malignant potential. SCTs that extend into the abdomen are difficult to completely resect and sometimes require an approach from both the sacrum and abdomen [2].

content in this topic is referenced in SCORE Teratoma overview

There's more to see -- the rest of this topic is available only to subscribers.

Last updated: January 30, 2022