Sacrococcygeal teratoma in children: Single center experience

Introduction: Sacrococcygeal teratoma (SCT) represent the most common benign and malignant germ cell tumors (GCT) in newborns and infants developing from primordial germ cells of the human embryo. Most of them are benign, however those presenting later in life and having major intra-pelvic component have greater malignant potential. Early and complete excision of the SCT has been the mainstay of successful management. The aim of this study is to describe the patient's details, management done, histopathology of the tumor, recurrence and the over all outcome of patients with SCT. Materials and Methods: Patients with histological diagnosis of sacrococcygeal teratoma during the period of January 2014 and October 2016 were included in this retrospective observational study. Data was collected regarding age, gender, mode of presentation, associated anomalies, Altman’s classification, investigations, treatment modality, tumor histology according to type of tumour with margin of resection, and outcome of management. All the diagnosed cases of SCT presenting during the above duration were included for study. Results: Twenty eight patients were included in the study. Out of them 75% were females and 25% were males. 32.14% presented during neonatal period. 78.57% presented with external mass. The tumour was completely resected by sacral approach in 22 patients and by combined abdominosacral approach in 06 patients. Recurrence was detected in one patients (3.57%); with Altman types 1 mature teratoma. Patients were followed for a duration ranged between 1 months and 3 years. Conclusion: Early diagnosis and early complete enblock excision of the tumor with the coccyx was mainstay of treatment with good prognosis. Late presentation and the presence of malignant changes are associated with poor prognosis. Intraoperative spillage of the tumor should be avoided. Overall survival of SCT is high.

[1]  F. Rescorla Teratomas and Other Germ Cell Tumors , 2012 .

[2]  G. Mychaliska,et al.  Benign sacrococcygeal teratoma with spinal canal invasion and paraplegia. , 2011, Journal of pediatric surgery.

[3]  J. Laberge,et al.  chapter 70 – TERATOMAS, DERMOIDS, AND OTHER SOFT TISSUE TUMORS , 2010 .

[4]  L. van de Schoot,et al.  Factors associated with recurrence and metastasis in sacrococcygeal teratoma , 2006, The British journal of surgery.

[5]  H. McDowell,et al.  Sacrococcygeal teratoma--a 25-year experience in a UK regional center. , 2006, Journal of pediatric surgery.

[6]  Shailesh Patel,et al.  Outcome of antenatally diagnosed sacrococcygeal teratomas: single-center experience (1993-2004). , 2006, Journal of pediatric surgery.

[7]  S. Bittmann,et al.  Surgical experience and cosmetic outcomes in children with sacrococcygeal teratoma. , 2006, Current surgery.

[8]  H. Isaacs Perinatal (fetal and neonatal) germ cell tumors. , 2004, Journal of pediatric surgery.

[9]  A. Sasco,et al.  The epidemiology of neonatal tumours , 2003, Pediatric Surgery International.

[10]  A. Sasco,et al.  The epidemiology of neonatal tumours. Report of an international working group. , 2003, Pediatric surgery international.

[11]  C. Stolar,et al.  Complete surgical excision is effective treatment for children with immature teratomas with or without malignant elements: A Pediatric Oncology Group/Children's Cancer Group Intergroup Study. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[12]  H. Gadner,et al.  Teratomas in infancy and childhood. , 1998, Medical and pediatric oncology.

[13]  P. Dillon,et al.  Long-term outcome for infants and children with sacrococcygeal teratoma: a report from the Childrens Cancer Group. , 1998, Journal of pediatric surgery.

[14]  C. Albanese,et al.  A surprising histological evolution of preterm sacrococcygeal teratoma. , 1998, Journal of pediatric surgery.

[15]  P. Thorner,et al.  Congenital teratomas of the head and neck. , 1997, The Journal of otolaryngology.

[16]  R. Motzer,et al.  Germ Cell Tumors , 2012 .

[17]  J. L. Buck,et al.  Germ cell tumors of the sacrococcygeal region: radiologic-pathologic correlation. , 1994, Radiographics : a review publication of the Radiological Society of North America, Inc.

[18]  R. Bilik,et al.  Malignant benign neonatal sacrococcygeal teratoma. , 1993, Journal of pediatric surgery.

[19]  D. Harms,et al.  Immature teratomas of childhood. Report of 21 cases. , 1985, Pathology, research and practice.

[20]  G. D'angio,et al.  Treatment strategies for infants with malignant sacrococcygeal teratoma. , 1981, Journal of pediatric surgery.

[21]  J. Opitz,et al.  Developmental terms—some proposals: First report of an International working group , 1979 .

[22]  R. Drury Mucosal Biopsy of the Gastrointestinal Tract (Volume 3 in the Series Major Problems in Pathology) , 1974 .

[23]  J. Randolph,et al.  Sacrococcygeal teratoma: American Academy of Pediatrics Surgical Section Survey-1973. , 1974, Journal of pediatric surgery.