Giant sacrococcygeal teratoma embolization

Rossi, Umberto; Cariati, Maurizio; Tomà, Paolo

doi:10.4103/0971-3026.116571

Cited by 12 publications

(11 citation statements)

References 3 publications

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“…In the case of our patient, once stabilized with tracheostomy after EXIT, we found the tumor to have a highly abundant blood supply. Although pre-excision embolization was described sporadically in cases of sacral teratoma [4, 8], we found no literature on embolization in cases of cervical teratomas. We assumed that embolization prior to definite surgical resection of the tumor could decrease significantly the blood loss and risk for complications or death during the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Although these lesions are usually histologically benign, they are usually large, and when they are located in the neck, perinatal mortality can be high as a result of upper airway obstruction [3]. Once the airway is secured, the resection of a highly vascularized, congenital giant teratoma can still be a fatal procedure due to massive bleeding of the tumor [4].…”

Section: Introductionmentioning

confidence: 99%

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Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report

et al. 2019

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Background A giant congenital cervical teratoma is often highly vascularized; thus, in addition to a life-threatening airway occlusion at birth it comprises a high risk for significant and lethal blood loss during resection. In the case presented, an endovascular embolization of the carotid artery that supplied a giant congenital cervical teratoma was done as part of a three-stage treatment soon after birth and contributed to an overall good outcome. Embolization in cases of cervical teratomas was not described previously. Case presentation We present a case of a preterm newborn from a Sephardic jewish origin with a giant, highly vascularized, congenital cervical teratoma that was managed successfully in three stages: (1) delivery by an ex utero intrapartum treatment procedure after extensive preoperative planning and followed by tracheostomy, (2) endovascular embolization of the carotid artery that supplied the tumor in order to decrease blood loss during resection, and (3) complete surgical resection. The parents were involved in all the ethical and medical decisions, starting just after the cervical mass was diagnosed prenatally. Conclusion The management of giant congenital cervical teratoma is often challenging from both a medical and ethical prospective. Meticulous perinatal planning and parents’ involvement is crucial. Endovascular embolization of the tumor feeding vessels can significantly improve the resection outcome and overall prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report

et al. 2019

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“…Embolization is generally performed by coils, which allow a more precise handling at the given location, immediately stopping the bleeding, especially when little vessels are concerned [4]. …”

Section: Discussionmentioning

confidence: 99%

Spontaneous Hematoma of the Rectus Sheath: Urgent Embolization with Squidperi Liquid Embolic Device

Torcia

Rossi

Squarza

et al. 2017

Case Reports in Radiology

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“…35,37 Although there were no reports on the improvement of vital prognosis, all patients who underwent IVR survived, and the tumor was able to be easily removed in two cases. 37,38 Persistent blood transfusion and hyperkalemia, however, caused difficulty in intraoperative management, with intraoperative cardiac arrest in one case. 37 During subsequent tumor resection, there was little bleeding in three of four cases.…”

Section: Guideline Formulation Methodsmentioning

confidence: 99%

“…The four cases of IVR performed in neonates with SCT were all transcatheter arterial embolization, including one case in which radiofrequency ablation (RFA) was carried out prior to birth, and one case in which RFA was performed as an additional treatment after embolization . The maximum diameter of all tumors treated was ≥10 cm.…”

Section: Recommendationsmentioning

confidence: 99%

Japanese clinical practice guidelines for sacrococcygeal teratoma, 2017

Fumino

Tajiri

Usui

et al. 2019

Pediatrics International

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Background Sacrococcygeal teratoma (SCT) is the most common extragonadal germ cell tumor in neonates and infants. Although most cases of infantile SCT are benign tumors by nature, some develop into extremely large lesions, leading to massive bleeding, high‐output heart failure, disseminated intravascular coagulation, and even fatal outcomes during the neonatal period. In addition, some patients may present with tumor recurrence, malignant transformation, long‐term sequelae (including bladder and bowel dysfunction) and lower leg palsy during the long‐term follow up. SCT, however, is very rare, and there are few opportunities to encounter this disease, therefore general physicians without expert credentials currently lack information relevant to clinical practice. For this reason, the research project committee has compiled guidelines concerning SCT. Methods The purpose of these guidelines was to share information concerning the treatment and follow up of infantile SCT. The guidelines were developed using the methodologies in the Medical Information Network Distribution System. A comprehensive search of the English‐ and Japanese‐language articles in PubMed and Ichu‐Shi Web identified only case reports or case series, and the recommendations were developed through a process of informal consensus. Results The clinical questions addressed the risk factors, the efficacy of cesarean section, the initial devascularization of tumor feeding vessels, interventional radiology, recommended clinical studies for follow up and possible long‐term complications. Conclusions These are the first guidelines for SCT to be established in Japan, and they may have huge clinical value and significance in terms of developing therapeutic strategies and follow up, potentially contributing to the improvement of the prognosis and quality of life of SCT patients.

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Giant sacrococcygeal teratoma embolization

Cited by 12 publications

References 3 publications

Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report

Three-step management of a newborn with a giant, highly vascularized, cervical teratoma: a case report

Spontaneous Hematoma of the Rectus Sheath: Urgent Embolization with Squidperi Liquid Embolic Device

Japanese clinical practice guidelines for sacrococcygeal teratoma, 2017

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