Adenocarcinoma Within a Paracoccygeal Teratoma in an Adult: Report of a Case

Abstract

We report an unusual case of adenocarcinomatous transformation of a paracoccygeal teratoma (PCT) in a 44-year-old woman. The patient was referred to us for surgical treatment of a growing paracoccygeal mass. The findings of a magnetic resonance imaging scan were compatible with soft tissue malignancy. Using the posterior approach, we performed complete surgical removal with coccygectomy. Histological examination of the cystic mass revealed a mature teratoma containing primary adenocarcinoma. The patient has been followed up for 7 years and is free of disease. Because prognosis depends on complete excision, we emphasize the importance of clear-margin surgery, including en bloc removal of the coccyx.

Extragonadal Germ Cell Tumors: A Review With Emphasis on Pathologic Features, Clinical Prognostic Variables, and Differential Diagnostic Considerations

“…Nearly all such reported cases are adenocarcinomas. [54][55][56][57][58] Incomplete resection of a neonatal mature teratoma has been reported to recur in adulthood as adenocarcinoma. 59,60 The presence of a nongerm cell malignancy in a SCGCT is a poor prognostic feature and 61 in 1974 and other earlier case reports found that benign tumors were overwhelmingly predominant.…”

Sacral Rheumatoid Nodule: An Unusual Indication for Coccygectomy

“…The age of 8 female and 2 male patients ranged from 20 to 77 years (mean 51:1 ± 20:6). Diagnoses included carcinoid tumor [11], paracoccygeal teratoma [12,13], epithelial cyst [14], mature teratoma [15], sacrococcygeal chordoma [16], sacral giant cell tumor [17], rectal carcinoma metastasis [18], and benign dermoid cyst [19]. Coccygectomy was the first-line therapy in 8 patients following failure of conservative management or was performed after failure of antibiotics or chemotherapy (Table 1).…”