Sacrococcygeal Teratoma: A 4-Year Experience at Komfo Anokye Teaching Hospital

Abstract

Background: Sacrococcygeal teratoma (SCT) is the most common solid neoplasm in neonates with an estimated prevalence of 1 in 40000 live births. The purpose of this study is to review the clinical characteristics and determine the outcome of surgical treatment ofneonates and children with SCT in our environment.Methods: A retrospective review of all patients treated for SCT at the paediatric surgery unit between January 2006 and February 2010 was conducted and the results analysed.Results: In all, 18 children were treated over the study period with a female preponderance of 3.5:1. Eleven patients (61%) presented by the 2nd week of life with a modal age of 5 days. The oldest child was 2.5yrs. Fifteen (83%) tumours were classified as Altman typeI whilst 16 (88.9%) and 17 (94.4%) were respectively cystic and benign. Ultrasonography was the imaging investigative tool used. The largest tumour measured 35cm by 26cm. There was no correlation between age and size of tumour. Excision of tumour was by sacralapproach via a chevron incision mostly as an elective procedure. Six (33.3%) were done as emergency procedures for various reasons. There was 89.9% surgical site infection with varying degrees of wound dehiscence. One child had a sigmoid colostomy on accountof repeated wound breakdown from faecal contamination. Most patients do not comply with follow-up appointments.Conclusion: Sacrococcygeal teratoma is mostly a benign tumour and prompt and complete surgical excision will provide good prognosis. Complex investigative tools are usually not necessary in the management of patients with this tumour. We recommend education of parents on the necessity to comply with followup appointments in order to capture long term sequelae.