Adult sacrococcygeal teratoma with coccygectomy: A case report with a review of the literature

Abstract

Background:Saccrococcygeal teratomas (SCT) are derived from embryonic germ cell layers. They frequently present at the base of the coccyx within the pelvis. While these tumors are common in children, they are exceedingly rare in adults. In adults, a majority of these tumors are intrapelvic and associated with a low risk of malignant transformation. Therefore, this contributes to a good prognosis following resection of mostly benign lesions.Case Description:An adult female with chronic pelvic pain presented with a sacral teratoma. She failed conservative treatment and underwent a coccygectomy with an en-bloc excision of the tumor. Microscopic histological analysis showed no evidence of immature or malignant elements, confirming the diagnosis of a mature, benign, cystic SCT.Conclusions:Mature SCTs in adults are rare malignant lesions. In this case, the patient was cured following primary surgical excision requiring en-bloc coccygectomy.

Case Report on Sacro-Coccygeal Teratoma in 5 Year Old Girl: A Case Report of Late Presentation

“…Sacrococcygeal teratoma is a tumour that develops in the sacrococcygeal area that incorporate tissue from many primitive germ layers. [6] Its cause remains unknown [7] The classification of SCT according to AAPSS American Academy of pediatrics surgical section (AAPSS) in 1973 described as follows.…”

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).…”

Adult case of giant sacrococcygeal teratoma: case report

“…MRI has superior specificity and accuracy than CT to visualize the soft-tissue extent in SCT [4]. Elevation of serum tumor markers such as alpha-feto protein (AFP), carcinoembryonic antigens (CEA), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH) are usually suggestive of malignant transformation [1,4,7,11].…”

“…Most adults can be asymptomatic or present with pressure symptoms [6,9,10]. Symptoms of mass effect can result in constipation, pain in sacrococcygeal region, bladder dysfunction, venous engorgement of lower limbs and neurological symptoms [1,3,9,11]. Intra-pelvic masses are common in adults, in contrast to neonates where more than 90% present as extra pelvic masses [1,3,4,9].…”

“…Most of these tumors are benign and cystic in nature, with only 1–2% of them having malignant transformation. Malignancy is more common as the patient ages [ 1 , 3 – 7 ]. The incidence of malignancy in the neonatal period is approximately 10%, compared with almost 100% by the age of 3 years [ 1 , 2 ].…”