Fetal teratomas: Antenatal diagnosis and clinical management

Abstract

Four cases of fetal teratomas arising from the sacrococcygeal and oropharyngeal areas are reported. The diagnosis, method of management, and grade of tumor are compared with previous experience in the literature. Pharyngeal lesions carry a worse prognosis for survival compared to the more common sacrococcygeal type (SCT). Atraumatic delivery and early repair of the lesion contribute to prolonged survival and lack of complications in cases of sacrococcygeal teratomas.

Prenatal sonographic diagnosis of congenital sacrococcygeal teratoma and management

“…This case report agrees with previous reported cases in which successful management of sacrococcygeal teratomas could be achieved with accurate prenatal sonographic diagnosis, atraumatic delivery, and prompt surgical intervention [2,7,9,17].…”

“…With the more frequent use of sonography, congenital sacrococcygeal teratomas are increasingly diagnosed antepartum [2,6,7,9,10,14,17]. Once the diagnosis is made, serial sonographic examinations have been advocated [2,9,17].…”

“…With the more frequent use of sonography, congenital sacrococcygeal teratomas are increasingly diagnosed antepartum [2,6,7,9,10,14,17]. Once the diagnosis is made, serial sonographic examinations have been advocated [2,9,17]. Sonography allows not only measurements of the tumor, but also its characterization as to whether it is predominantly solid or cystic, its documentation as to growth or changes in the tumor itself during pregnancy, and facilitates interventional procedures such as transabdominal puncture prior to cesarean section [12].…”

“…Teal et al [17] considered that an infant with a sacrococcygeal teratoma measuring more than -cm in average must be delivered by cesarean section, but Gross et al [7] considered 5-cm to be the critical limit. We consider that every infant with a sacrococcygeal teratoma, without associated anomalies incompatible with life, must be delivered by cesarean section, since the average size of the tumor is added to the normal dimensions of the fetal girdle.…”

“…An absolutely atraumatic vaginal delivery in these cases is therefore not warranted. Using either the classical cesarean section [17] or the low-segment cesarean section with an inverted T-shaped hysterotomy provide the least traumatic approaches to the fetus. Since these tumors are potentially malignant and the incidence of malignancy increases with age, complete resection of the tumor with excision of the coccys in the first week of life and pathologic examination of the resected mass are mandatory [5,16,18].…”