Benign Sacrococcygeal Teratomas in Infants and Children A 25 Year Review

Ein, Sigmund H.; Adeyemi, S. Debo; Mancer, Kent

doi:10.1097/00000658-198003000-00020

Cited by 79 publications

(52 citation statements)

References 9 publications

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“…3 SCT is not a neural tube defect, and there is typically no spinal dysraphism, though there may be occasional sacral dysgenesis or hemivertebrae. 4 Neonates with SCT have an excellent prognosis depending on surgical resection and malignant potential.…”

Section: Discussionmentioning

confidence: 99%

Terminal Myelocystocele and Sacrococcygeal Teratoma: A Comparison of Fetal Ultrasound Presentation and Perinatal Risk

Yu¹,

Sohaey²,

Kennedy³

et al. 2007

American Journal of Neuroradiology

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SUMMARY:This case exemplifies the difficulty in differentiating cystic sacrococcygeal teratoma and terminal myelocystocele. Fetal sonography presentation and perinatal risks of sacrococcygeal teratoma and terminal myelocystocele are compared, and we emphasize the importance of obtaining fetal MR imaging to establish an accurate diagnosis.T he terminal spine presents unique imaging challenges, particularly in the case of large cystic masses. In the first case, an isolated terminal myelocystocele mimicked a cystic sacrococcygeal teratoma (SCT) on prenatal sonography. The second case of type 2 (SCT) is presented for comparison. We discuss the presentation and perinatal risks of these 2 cystic sacrococcygeal masses and illustrate surgical correction of a cystic terminal myelocystocele. Case Reports Index CaseA 22-year-old gravida 2, para 1 was referred to us for investigation of a fetal mass. Maternal serum alpha-fetoprotein (AFP) levels were mildly elevated, and amniocentesis results were a healthy female with normal acetylcholinesterase levels.At 30-weeks gestational age, sonography showed a cystic exophytic lower pelvic mass measuring 8 ϫ 7 ϫ 6 cm. The mass was skin-covered and septate ( Fig 1A, -B). It appeared to originate from the tip of an otherwise normal sacrum. Fetal calvaria views were normal, without Chiari II malformation. Amniotic fluid index (AFI) measured 21 cm, and fetal size was appropriate for gestational age. The size, location, and cystic composition of the mass and the perceived absence of skeletal dysraphism and Chiari II malformation supported the diagnosis of cystic SCT with complicating polyhydramnios. Fetal MR imaging was recommended to better characterize the mass; however, the patient refused due to claustrophobia. The follow-up fetal sonography at 36 weeks showed the mass had grown (10 ϫ 10 ϫ 6 cm) and the AFI had increased to 24 cm.At 37 weeks, the neonate was delivered via classic cesarean delivery without complications, weighing 3765 g with Apgar scores of 2, 5, and 8, at 1, 5, and 10 minutes, respectively. The mode of delivery was based on the prenatal diagnosis of a large SCT.Neonatal CT and MR imaging of the congenital cyst and spine revealed sacral spinal dysraphism and tethered cord (Fig 1C, -D). The diagnosis was revised to terminal myelocystocele.Surgical exploration was undertaken at 7 days of life ( Fig 1E, -F). The large cyst was entered and found to contain clear CSF in a terminal continuation of the spinal subarachnoid space. A second thinwalled cyst encountered at the base of the larger cyst represented terminal dilation of the spinal cord central canal (Fig 1G). These findings are diagnostic of terminal myelocystocele.1 Opening the second cyst revealed the true spinal canal, with lipomatous distal tethering of the cord to the dorsal and cranial aspect of the myelocystocele ( Fig 1H). Primary spinal cord untethering was undertaken, and the spinal canal was closed by using duraplasty material. Postoperatively, the neonate retained normal neurologic and urologic function....

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Section: Discussionmentioning

confidence: 99%

Terminal Myelocystocele and Sacrococcygeal Teratoma: A Comparison of Fetal Ultrasound Presentation and Perinatal Risk

Yu¹,

Sohaey²,

Kennedy³

et al. 2007

American Journal of Neuroradiology

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“…One pa ent died of sep caemia on 10 th post-opera ve day. 10,11 . In recent years, antenatal detec on of the Sacrococcygeal mass has increased manifold in western world due to be er imaging modali es and with ter ary care services at doorsteps, antenatal detec on has enabled be er outcome.…”

Section: Resultsmentioning

confidence: 99%

“…SSIs are considered to be due to proximity to anal opening and con nuous faecal soiling of wound. Ein SH et al reports an infec on rate of 18% in surgical wound 10 . In another study by Wakhlu et al surgical site infec on was seen in only two pa ents 9 .…”

Section: Discussionmentioning

confidence: 98%

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

Kundal

Jadhav

Gupta

et al. 2015

J. Nepal Paedtr. Soc.

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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

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“…Incidentally, there was no other congenital defect in her body. Body of knowledge has since then increased with numerous reports from USA [2][3][4][5][6][7], Canada [8,9], and The Netherlands [10]. Therefore, I propose to report cases which occurred in a Nigerian community whose surgical specimens I had handled personally.…”

Section: Introduction Abstractmentioning

confidence: 99%

Sacrococcygeal Teratoma in a Developing Community

Onuigbo¹

2015

Journal of Case Reports and Studies

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Benign Sacrococcygeal Teratomas in Infants and Children A 25 Year Review

Cited by 79 publications

References 9 publications

Terminal Myelocystocele and Sacrococcygeal Teratoma: A Comparison of Fetal Ultrasound Presentation and Perinatal Risk

Terminal Myelocystocele and Sacrococcygeal Teratoma: A Comparison of Fetal Ultrasound Presentation and Perinatal Risk

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

Sacrococcygeal Teratoma in a Developing Community

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