Antenatal diagnosis of a sacrococcygeal teratoma (original) (raw)
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Case Reports in Perinatal Medicine
Objectives The congenital embryonic tumor known as sacrococcygeal teratoma (SCT) affects 1 in 35.000–40.000 newborns and is more prevalent in female fetuses and neonates. A total of 25–50% of SCTs are diagnosed by an ultrasound (US) examination during the second trimester of pregnancy. Planning the manner of delivery, determining the risk of negative outcomes, and choosing treatment options depend on the results of antenatal differential diagnosis. Case presentation This is a unique case of a 29-year-old second gravida, suspected of having a fetal sacrococcygeal dysplasia differentiable between Type 2 SCT and terminal myelocystocele. An MRI revealed no typical SCT changes, as a matter of course, the diagnosis of myelocystocele could not have been excluded. The results of the genetic examination allowed to exclude the chromosomal pathology. Punctuation of the external component of the formation and a cytological examination were suggested. Nevertheless, the patient and her partner re...
Foetal sacrococcygeal teratoma: extremes in clinical presentation
Singapore medical journal, 2011
Sacrococcygeal teratoma (SCT) is a congenital tumour that can be diagnosed by ultrasonography (USG). We present our experience with the management of two cases of SCT in our institution between 2008 and 2009. In the first case, SCT was diagnosed at 17 weeks' gestation. The patient was followed up with fortnightly USG to monitor the tumour size, foetal growth and signs of foetal hydrops. The patient delivered a baby girl by Caesarean section at 37 weeks, with good Apgar scores. The neonate underwent an uneventful resection of SCT on Day 1 of life. In the second case, SCT was diagnosed at 20 weeks during screening. In view of foetal hydrops and anaemia, the patient underwent three in utero foetal blood transfusions. A baby boy was delivered by Caesarean section at 28 weeks. There was a large friable SCT with massive haemorrhage. Despite maximal resuscitative efforts, the neonate died 30 minutes after birth.
Early Diagnosis of Fetal Sacrococcygeal Teratoma: A Case Report
The Kaohsiung Journal of Medical Sciences, 2003
Sacrococcygeal teratoma is a rare fetal neoplasm with an incidence of 1 in 40,000 births. Antenatal diagnosis is usually made after 22 weeks of gestation. Fetuses with this malformation are at risk of significant perinatal morbidity and mortality. Malignant components, coexisting with life-threatening anomalies, and chromosomal abnormalities are rare. Postulated causes of perinatal death include hydrops, dystocia, tumor rupture, preterm labor secondary to polyhydramnios, and anemia due either to hemorrhage or hemolysis within the tumor. Herein, we present a case of fetal sacrococcygeal teratoma diagnosed as early as 17 weeks of gestation.
Journal of the Bahrain Medical Society, 2022
Sacrococcygeal teratoma (SCT) is the most commonly diagnosed congenital tumor during the neonatal period. The outcome of SCT is dependent on the growth rate, the presence of solid components in cancer, and the presence or absence of high flow cardiac involvement of the fetus. This case report presents the management and outcome of a pregnant woman carrying a fetus with a rapidly growing SCT. Confirmation of diagnosis was based on the universal prenatal ultrasound examination standards. Eventually, the patient delivered a girl weighing 2.9 kg, including the neoplasm, by a planned Cesarean section. The newborn received one dose of surfactant and underwent complete resection of the teratoma on the second day with a favorable outcome. This case report aims to show that rapidly growing SCT requires frequent antenatal follow-up with serial prenatal ultrasound examinations, optimum timing, mode, and appropriate place of delivery for a better fetal outcome.
Prenatal sonographic features of sacrococcygeal teratoma
International Journal of Gynecology & Obstetrics, 1999
Objecti¨e: To describe the potential role of ultrasound in prenatal diagnosis of fetal sacrococcygeal teratoma Ž. SCT. Subjects: A total of four fetuses with prenatal diagnosis of SCT were sonographically evaluated and followed-up. Results: Fetal SCT was diagnosed at 13, 17, 26 and 27 weeks of gestation. Three of them had predominantly solid tumors with scattered cystic areas, whereas the other one had an entirely cystic tumor. One had a rapid growth tumor and finally developed early hydrops. Three had polyhydramnios and delivered prematurely. The diagnosis was posnatally confirmed in all cases. In the case with the large tumor, a cesarean section was done to avoid traumatic delivery. Two cases survived and the tumors were successfully resected, whereas the others died due to heart failure secondary to hydrops in one case and prematurity in the other one. Conclusion: This small series suggests that SCT be readily diagnosed in utero, possibly as early as first trimester. The important clue was an abnormal mass in the sacrococcygeal area. The prenatal diagnosis can contribute to changes in clinical decision. ᮊ
Prenatal Diagnosis and Management of Sacrococcygeal Teratoma
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 1999
Sacrococcygeal teratomas (SCT) represents a group tumors deriving from the primordial germ cells. It is the most common tumor affecting neonates, with a female to male ratio of almost 4:1.78. SCT are either benign (mature) or malignant (immature) with different outcome. With advancements in ultrasonography, more SCT are diagnosed prenatally. magnetic resonance imaging (MRI) is more accurate in describing the intrapelvic and abdominal extent of the tumor. Most fetal teratomas could be managed by planned delivery and postnatal surgery. The earlier the diagnosis and surgical intervention, the better the prognosis. A complete surgical excision of the tumor is necessary, including coccygectomy, to prevent recurrence. At the time of birth, most lesions are benign and surgical resection can be accomplished with relatively low morbidity and mortality. Recurrence is reported as 2-35% in patients with immature teratomas, tumor spillage, incomplete resection or failure to remove the coccyx. A long-term follow-up is required for any urinary or bowel dysfunction.
Prenatal Diagnosis and Management of Sacrococcygeal Teratomas
IntechOpen eBooks, 2019
Sacrococcygeal teratomas (SCT) represents a group tumors deriving from the primordial germ cells. It is the most common tumor affecting neonates, with a female to male ratio of almost 4:1.78. SCT are either benign (mature) or malignant (immature) with different outcome. With advancements in ultrasonography, more SCT are diagnosed prenatally. magnetic resonance imaging (MRI) is more accurate in describing the intrapelvic and abdominal extent of the tumor. Most fetal teratomas could be managed by planned delivery and postnatal surgery. The earlier the diagnosis and surgical intervention, the better the prognosis. A complete surgical excision of the tumor is necessary, including coccygectomy, to prevent recurrence. At the time of birth, most lesions are benign and surgical resection can be accomplished with relatively low morbidity and mortality. Recurrence is reported as 2-35% in patients with immature teratomas, tumor spillage, incomplete resection or failure to remove the coccyx. A long-term follow-up is required for any urinary or bowel dysfunction.
Sacrococcygeal teratoma: prenatal assessment, fetal intervention, and outcome
Journal of Pediatric Surgery, 2004
To understand the natural history and define indications for fetal intervention in sacrococcygeal teratoma (SCT), the authors reviewed all cases of fetal SCT presenting for evaluation. Methods: Prenatal diagnostic studies including ultrasound scan, magnetic resonance imaging (MRI), echocardiography and pre-and postnatal outcomes were reviewed in 30 cases of SCT that presented between September 1995 and January 2003. Results: The mean gestational age (GA) at presentation was 23.9 weeks (range, 19 to 38.5) with 3 sets of twins (10%). Overall outcomes included 4 terminations, 5 fetal demises, 7 neonatal deaths, and 14 survivors. Significant obstetric complications occurred in 81% of the 26 continuing pregnancies: polyhydramnios (n ϭ 7), oligohydramnios (n ϭ 4), preterm labor (n ϭ 13), preeclampsia (n ϭ 4), gestational diabetes (n ϭ 1), HELLP syndrome (n ϭ 1), and hyperemesis (n ϭ 1). Fetal intervention included cyst aspiration (n ϭ 6), amnioreduction (n ϭ 3), amnioinfusion (n ϭ 1), and open fetal surgical resection (n ϭ 4). Indications for cyst aspiration and amnioreduction were maternal discomfort, preterm labor, and prevention of tumor rupture at delivery. Although 15 SCTs were solid causing risk for cardiac failure, only 4 fetuses met criteria for fetal debulking based on ultrasono-graphic and echocardiographic evidence of impending high output failure and favorable anatomy at 21, 23.6, 25, and 26 weeks' gestation. Intraoperative events included maternal blood transfusion (n ϭ 1), fetal blood transfusion (n ϭ 2), chorioamniotic membrane separation (n ϭ 2), and fetal arrest requiring successful cardiopulmonary resuscitation (CPR) (n ϭ 1). In the fetal resection group, 3 of 4 survived with mean GA at delivery of 29 weeks (range, 27.6 to 31.7 weeks), mean birth weight of 1.3 kg, hospital stay ranging from 16 to 34 weeks, and follow-up ranging from 20 months to 6 years. Postnatal complications in the fetal surgery group included neonatal death (n ϭ 1, secondary to premature closure of ductus arteriosus with cardiac failure), embolic event (n ϭ 1, resulting in unilateral renal agenesis, jejunal atresia), chronic lung disease (n ϭ 1), and tumor recurrence (n ϭ 1). Conclusions: For fetal SCT, the rapidity at which cardiac compromise can develop and the high incidence of obstetric complications warrant close prenatal surveillance. Amnioreduction, cyst aspiration, and surgical debulking are potentially life-saving interventions.