Sacrococcygeal teratoma with preterm delivery: a case report

Abstract

Background: Sacrococcygeal teratoma is one of the most frequently prenatally diagnosed neoplasias. Obstetric ultrasound has a role in the diagnosis and management of these tumors during pregnancy. In this report, we describe a multidisciplinary approach in a case of a patient with sacrococcygeal teratomas and preterm delivery, as well as postnatal outcomes. Case presentation: A 26-year-old Caucasian woman at 20.3 weeks of gestation with a normal gestational course and no relevant medical or surgical history was referred to our institution with a sacrococcygeal mass diagnosis. Magnetic resonance imaging confirmed the diagnosis of sacrococcygeal teratoma type I according to the Altman classification. Follow-up with ultrasound showed an increase in the size of the mass up to 190 × 150 mm, high Doppler flow, and severe polyhydramnios. At 35.1 weeks of gestation, the patient had premature rupture of membranes, and an emergency cesarean section was performed due to recurrent late decelerations detected by fetal heart rate monitoring. Afterward, surgery was performed successfully at 36 hours of life. Posterior controls revealed normal and healthy child growth. Conclusions: This case report demonstrates the importance of a multidisciplinary approach to offer the best neonatal outcomes by performing early surgery, as well as the need for follow-up by ultrasound in order to minimize complications by assessing mass growth, Doppler flow, and amniotic fluid.

The Sonographic Diagnosis and Clinical Management of a Fetal Sacrococcygeal Teratoma: A Case Report

“…9 Teratomas can be asymptomatic or may cause rectal or bladder obstruction, related to tumor growth. 7 Rapid growth of the mass may cause pressure on adjacent organs, such as rectum or bladder resulting in organ dysfunction (e.g., fecal or urine incontinence). 12 Several parameters can be used to predict the prognosis of SCT.…”

“…6 A 3-year postoperative surveillance should include serum AFP, beta-human chorionic gonadotropin, and physical examination, every 3 to 6 months, as well as assessing the risk for surgical complications, recurrence, residual tumor, and malignancy. 7,9,12 Long-term surgical complications have been reported, including urologic and anorectal dysfunction with an incidence of 33% and 29%, respectively. 5 This case report discussion has the limitation that sources published in English were used for references, which may have resulted in missing information and or knowledge gaps.…”

“…4,5 However, a male infant diagnosed with SCT is more commonly affected by a malignant degeneration. 6,7 Sacrococcygeal teratoma is of unknown etiology and can be detected prenatally with sonography, as early as 13-week gestation. 1 When the teratoma is detected, it is described as cystic, solid, or having mixed components, and most of these are identified with cystic components.…”

“…4,5 However, a male infant diagnosed with SCT is more commonly affected by a malignant degeneration. 6,7…”

Transient Polyhydramnios during Pregnancy Complicated with Gestational Diabetes Mellitus: Case Report and Systematic Review

“…Data from this review highlight a low percentage of studies based on polyhydramnios associated with GDM. Baro et al [ 44 ] reported a case of a pregnancy complicated with GDM but also with an associated fetal abnormality, sacrococcygeal teratoma. Comparing this case report with ours, there are some similarities, namely, the good neonatal outcome and the necessity of cesarean delivery due to abnormal fetal heart rate.…”