The Outcome of Sacrococcygeal Teratoma: A Multicenter Study in Iraq

Abstract

Background: Sacrococcygeal teratoma (SCT) is one of the most common solid tumors in theneonate. They are more common in females and presented as sacral masses. They require an earlysurgical resection with regular follow-up.Objectives: To evaluate the SCTs regarding the perinatal variables, clinical characters, pathological features, management options, and outcome.Materials and methods: A prospective study of 37 patients with SCTs were admitted topediatric surgery departments in Ramadi (west of Iraq) and Mosul city (north of Iraq) during theperiod from December 2013 to December 2018. The detailed data of each patient were recordedand analyzed including history, physical examination, investigations, management, and follow-up.Results: There were 23 (62%) females and 14 (38%) males. The ages were ranged from 1 dayto 2 years. Fifty-one percent were diagnosed prenatally by ultrasound and 30% of them weredelivered by Caesarean section. Among the neonatal age group (28 patients),75% were born at fullterm, their median birth weight was 3100 g. Associated anomalies were 3%. Plain X-ray of thetumors was revealed calcification in 22%. The serum α-fetoprotein level was high at presentation.According to Altman classification, there were type I 54%, type II 40%, type III 3%, and type IV3%. Ninety-seven percent was presented as sacral mass and only 3% was presented with urinarytract obstruction. One (3%) was died a few hours after labor due to the rupture of the tumor.Surgical intervention was performed in 94% of patients. Macroscopically, 59% were mixed, 22%solid, and 19% cystic. Histologically, 92% had mature teratoma, 3% immature, and 6% malignantteratoma. Wound infection occurred in 10%, wound dehiscence in 3%, and poor cosmetic scar in8%. One (3%) patient had a recurrence.Conclusion: The proper management are important factors affecting the outcome in the perinatalperiod and early diagnosis with complete excision of the tumor. The size of the primary tumordoes not affect the recurrence and the outcome