Magnetic Resonance Imaging Verification of a Case of Sacrococcygeal Teratoma

Abstract

Although rare, sacrococcygeal teratoma is the most common congenital neoplasm, occurring in 1 in 40,000 infants. Approximately 75% of affected infants are female. The aim of the present study was to correlate ultrasonography and magnetic resonance imaging (MRI) findings in patients with fetal sacrococcygeal teratoma. Three pregnant women in 27th week of gestation underwent fetal MRI after ultrasonography examination, with findings suggestive for fetal sacrococcygeal teratoma. Tumor size, location, extent and content were evaluated both by MRI and ultrasonography. Findings regarding tumor location, size and content were similar for both methods. There was a large well-circumscribed mixed, cystic/solid oval mass, originating from right sacro-gluteal region and projecting into the amniotic cavity, 132 × 110 × 76 mm in size. The mass had a heterogeneous appearance. The T1 high signal suggested fat component of the tumor, while T1 and T2 hypointense components suggested calcified/bony components. There was also T1 hypointense component consistent with cystic and fluid component. The imaging findings were characteristic for sacrococcygeal teratoma. There was not obvious lumbar or thoracic spinal involvement. There was no gross intrapelvic or abdominal extension, and even sacrum and coccyx appeared deformed. The amount of amniotic fluid was increased. MRI was superior to ultrasonography in the evaluation of the exact tumor extent, accurately demonstrating pelvic involvement in all of the three cases. Fetal MRI has shown to be a valuable adjunct to obstetric sonography in the evaluation of fetal sacrococcygeal teratoma, because of its higher accuracy in the determination of tumors extent and content, playing a significant role in the therapeutic planning and increasing the chances of cure for these fetuses.

Prenatal MRI diagnosis and outcomes of abdominal or sacrococcygeal teratomas and parasitic fetuses

“…Sacrococcygeal teratoma occurs in approximately 1:35,000-40,000 births and affects approximately 1 in 27,000 pregnancies (11). Approximately 75% of affected infants are female (12). In our study, female patients accounted for 79.2% of the patients with sacrococcygeal teratomas.…”

An Aberrant Case of Sacrococcygeal Teratoma in a Female Infant Born of Twin Pregnancy

“…Meningocele, myelocystocele, myelomeningocele, teratoma, lipoma, hamartoma, lymphangioma, hemangioma, chordoma, and ependymoma are possible differential diagnoses of fetal sacrococcygeal masses [ 4 ]. Although, occasionally, there may be sacral dysgenesis or hemivertebrae, SCT is not primarily a neural tube abnormality and there is usually no spinal dysraphism [ 5 ].…”