Abstract
BackgroundSacrococcygeal teratoma is one of the most common congenital tumors in newborns and infancy. The incidence is 1 per 20,000–40,000 live births. Ultrasonography is an optimal method for prenatal screening and diagnosis of fetal sacrococcygeal teratoma. MRI can be used to assist in the diagnosis. However, sacrococcygeal teratoma in the twin pregnancy is rare.Case presentationWe reported a case of one twin with sacrococcygeal teratoma in dichorionic-diamniotic twin pregnancy.One twin with sacrococcygeal teratoma was diagnosed at the second trimester by ultrasonic examination and another twin was normal. A regular and careful antenatal care was conducted by the multidisciplinary team. The parents refused to perform the fetal MRI and examine the chromosome of both twin.At 37 + 1 of gestation, planned cesarean section was performed. The healthy male co-twin (twin A) weighed 2880 g.The male twin with SCT (twin B) weighed 2900 g, complying with 6 × 3 × 3 cm cystic and solid mass in sacrococcygeal region. At four days of age twin B underwent excisional surgery of the sacrococcygeal teratoma and coccyx and discharged 7 days after surgery. The mother and both babies were followed up and are all in good health until now.Conclusion(s)Sacrococcygeal teratoma in twin pregnancy is rare. Early antenatal diagnosis is important. Once the sacrococcygeal teratoma is diagnosed, clinicians should be aware of the associated maternal and fetal complications. Expecting parents should be counseled by the multidisciplinary team about the management and prognosis of the STC twin and co-twin. Prompt surgical excision of the sacrococcygeal teratoma after birth should be suggested.
Highlights
Sacrococcygeal teratoma is one of the most common congenital tumors in newborns and infancy
We reported a case of one twin with SCT in dichorionic diamniotic twin pregnancy and the timely intervention allowed the survival of both twins
We used a list of keywords including “sacrococcygeal teratoma”, “twin pregnancy” and “multiple pregnancy” to perform an extensive search and conducted a literature review in English and Chinese about the perinatal management and postnatal outcomes of twin pregnancies compared with one fetus with prenatally diagnosed sacrococcygeal teratoma.Written informed consent was obtained from the couple before the procedure and manuscript publication
Summary
Teratoma originates from early embryonic pluripotent stem cells, and the Hensen’s node in front of the coccyx is the site where pluripotent stem cells are concentrated. During a routine second trimester ultrasound at 23 + 3 weeks’ gestation, a 3.2 cm mixed solid and cystic SCT starting from the sacral area was detected in one twin (twin B) with no other fetal abnormalities,and co-twin (twin A) with no abnormality. At 34 + 4 weeks’ gestation, on follow-up ultrasound, the fetus was detected with polyhydramnios and no signs of hydrops and the solid and cystic mass 6.3 × 2.7 × 2.9 cm (Fig. 1a and b).Planned cesarean section was performed at 37 weeks and 1 day. The male twin with SCT (twin B) weighed 2900 g with Apgar scores of 10 and 10 at 1 and 5 minutes, respectively, complying with 6 × 3 × 3 cm cystic and solid mass in sacrococcygeal region (Fig. 2).The neonate transferred to NICU due to SCT.
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