Giant Sacrococcygeal Teratoma Research Articles

Рідкісне спостереження одномоментного видалення гігантської крижово-куприкової тератоми з масивними пресакральним і зовнішнім компонентами та доопераційною ендоваскулярною оклюзією живлячих артерій пухлини в новонародженої дитини

Aim - to analyze and describe the experience of a one-moment removal of a giant sacrococcygeal teratoma (SCT), with massive presacral and external components (III type), and preoperative endovascular occlusion of the feeding arteries of the tumor, in a newborn, based on a clinical case. Clinical case. A unique clinical case of a giant SCT with massive presacral and external components and preoperative endovascular occlusion of the feeding arteries of the tumor in a newborn is presented. Features of perinatal support, preoperative endovascular occlusion of the feeding arteries of the SCT and surgical intervention are described, which are important elements of optimizing the treatment of children with this life-threatening pathology. Conclusions. In the diagnosis and treatment of SCT, a scientifically based, differentiated approach is necessary, which includes: early (up to 22 weeks of gestation) complex prenatal diagnosis for choosing rational tactics of pregnancy management, examination of the fetus, delivery by cesarean section, postnatal diagnosis, preoperative preparation and surgical treatment. The first described preoperative endovascular occlusion of the feeding arteries of the presacral and external components of the SCT provides tumor devascularization and minimization of intraoperative blood loss during one-moment resection of a highly vascularized giant tumor. Adequate assessment and rational conservative treatment of a severe complication of the early postoperative period - thrombosis of the infrarenal section of the aorta made it possible to eliminate the life-threatening complication and achieve complete recanalization of the thrombosed section of the aorta and restore full blood flow in the lower extremities. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting studies. No conflict of interests was declared by the authors.

Role of pre-operative endovascular embolization of a giant sacrococcygeal teratoma in neonate: a case report

BackgroundGiant sacrococcygeal teratomas (SCTs) are at risk of perinatal morbidity and mortality due to their high vascularity. Pre-operative embolization of the feeding arteries, prior to complete surgical resection, may assist in minimizing the intraoperative blood loss by occluding these feeding arteries.Case presentationWe present a case of a highly vascular giant SCT in a neonate, which was successfully embolized through an endovascular approach prior to surgery. The femoral artery approach was chosen, with access established using a Micropuncture introducer as a sheath. Embolization was performed using a combination of microcoils, Gelfoam slurry, and polyvinyl alcohol particles. The patient developed femoral artery spasm post-procedure, which resolved with the application of a glyceryl trinitrate patch.ConclusionsPerforming pre-operative endovascular embolization on a giant sacrococcygeal teratoma presents particular challenges, primarily due to the difficulty in assessing small vessels and the potential complications associated with this procedure. Nevertheless, this technique proves exceptionally valuable in helping the surgeon minimize blood loss during surgery, thereby reducing the risks of morbidity and mortality. Comprehensive planning for the embolization procedure is essential, encompassing the identification of potential vascular access points and alternatives, along with careful selection of the appropriate catheter.

SFM Fetal Therapy Practice Guidelines: Radiofrequency Ablation of Fetal Umbilical Cord

AbstractIn radiofrequency ablation (RFA), the ions in the tissue surrounding the probe's uninsulated tip are noticeably stirred up by the electrode's high-frequency alternating current. The surrounding tissue experiences thermal coagulation necrosis as a result of the frictional heat.RFA is used in complicated monochorionic twin pregnancies with selective fetal growth restriction (FGR), TRAP, and TTTS. RFA may also be considered in giant chorioangioma with favorable vascular anatomy and giant sacrococcygeal teratoma with imminent hydrops. It serves as a substitute to laser.

Giant sacrococcygeal teratoma in an infant: a case report with a literature review.

A sacrococcygeal teratoma (SCT) is a rare embryonal tumor that emerges in the sacrococcygeal area. It affects one in every 35000-40000 live births. Herein, we report a case of a substantial SCT in a neonate. A neonate girl from consanguineous parents was delivered by cesarean section with a large mass (18×17cm) in the sacrococcygeal area. The baby's birth weight was 5kg, of which 2.5 belonged to the mass. The vital signs were within normal ranges and she had weak movement with bluish peripheral limbs. Oxygen saturation was around 85% for a short period after birth. According to the American Academy of Pediatric Surgical Section, the tumor was type I. After the fifth day of delivery, a complete resection was done through a chevron incision. The patient was put on 'nil by mouth' for about 24h and given intravenous fluid. The histopathological examination of the surgical specimen confirmed extragonadal immature teratoma. The histological classification of SCT is divided into three types: malignant teratomas (consisting of malignant germ cells); immature teratomas (incompletely differentiated structures with a high risk of malignancy or embryonal components); and mature teratomas (fully differentiated tissues). SCT has rarely been reported as a giant mass. Radiologic examinations in the early stages of pregnancy may be essential to the early diagnosis of the condition.

Anesthetic Management of a Newborn with Giant Sacrococcygeal Teratoma

Anesthetic Management of a Newborn with Giant Sacrococcygeal Teratoma

VP52.02: Fetal laser surgery in giant sacrococcygeal teratoma

VP52.02: Fetal laser surgery in giant sacrococcygeal teratoma

Prenatal perineal findings and possible clinical scenario

The fetus’s perineal area has not traditionally been the focus for the prenatal echoscopy, mainly because adequate visualization depends on fetus’s position. However, it is precisely thanks to the targeted attention to the perineal area that we sometimes manage to find not only quite curious but clinically significant findings.Sacrococcygeal teratoma can grow large and affect the natural birth process. When localized in the perineal region, it sometimes leads to defecation and micturition disorders. In addition, intestinal loops may be located in the tumor structure, which leads to deformation and the risk of hernia formation. In the presence of a giant sacrococcygeal teratoma, the following events may occur: heart failure leading to fetal hydrops, obstruction of the urinary tract, obstruction of the gastrointestinal tract, impaired innervation of organs due to compression, intratumoral hemorrhage, intrauterine anemia. Hymenal pathology is quite rare in everyday clinical practice. Usually, it is one of the two most common nosologies: hymenal polyp or imperforate hymen. These two anomalies occur almost exclusively in childhood or immediately after menarche. At a later age, the preserved or dysmorphic hymen can present difficulties in diagnosing and treating intravaginal pathological processes. In this article, we would like to bring to your attention two clinical cases with different prognosis to draw colleagues’ attention to the need for a targeted assessment of the perineal area and correct prenatal counseling for a couple, because the ranking of the severity of the probable consequences is significant. Thus, some findings will require only adequate monitoring in childhood, others – may be the cause of premature birth, changes in delivery tactics or immediate surgery after birth.

Adult case of giant sacrococcygeal teratoma: case report

BackgroundSacrococcygeal teratomas are tumors originating from pluripotent embryonic germ cell layers located in the fetal coccyx. These tumors are highly vascular if they undergo malignant transformation. Typically, they are found in infants and children and occasionally can be diagnosed prenatally. Adult cases are very rare, and represent tumors present since birth with delayed detection.Case presentationWe describe a case of a giant sacrococcygeal teratoma in a 25 years old female college student presenting with right gluteal swelling of 4 months’ duration. In addition to the huge disfiguring mass on the perineal area, she also had lower abdominal pain, urinary complaints, and difficulty with ambulation.DiscussionPre-operative impression was of a sacrococcygeal mass and histopathology following complete surgical excision revealed a sacrococcygeal teratoma. She recovered well after surgery with no radiologic evidence of recurrence at six months.ConclusionAlthough rare, sacrococcygeal teratoma should be considered as a differential diagnosis for female adults presenting with perineal and/or pelvic masses. Complete surgical excision remains the mainstay of treatment.

Description of a giant hypothalamic hamartoma associated with an immature ruptured giant sacrococcygeal teratoma: a case report

Giant hypothalamic hamartomas (GHH) are rare neonatal intracerebral congenital malformations responsible for gelastic epilepsy and/or endocrine disturbances. Sacrococcygeal teratomas (SCT) are fetal neoplasms associated with perinatal morbidity and mortality, especially hemorrhagic complications in giant examples (GSCT). Here, we describe an immature ruptured GSCT complicated by hemorrhagic shock at 32-week gestation boy requiring an emergency delivery, followed immediately by urgent surgical removal. A brain lesion resembling a GHH was also present on the antenatal MRI. In order to exclude metastatic immature teratoma or glioma, a biopsy was performed by a retro-sigmoidal approach, which confirmed the nature of the hamartoma. Here, we describe for the first time the association of a ruptured immature GSCT associated with a GHH.

Anesthesia Concerns in the Management of Low Birth Weight Neonate for Giant Sacrococcygeal Teratoma Excision: Case Series of Two Cases

Anesthesia Concerns in the Management of Low Birth Weight Neonate for Giant Sacrococcygeal Teratoma Excision: Case Series of Two Cases

Giant Sacrococcygeal Teratoma in Neonate: A Case Report and Review of Literature

AbstractSacrococcygeal teratoma is considered the most common tumor in the neonatal period with a female-to-male ratio of 3–4:1. They are believed to arise early in gestation from the totipotential cells of Hensen’s node and the derived ectoderm, mesoderm, and endoderm. A 2.25 kg cesarean-delivered male, term neonate presented with large nonpulsatile, globular erythematous mass with lobulated surface and variable consistency. Magnetic resonance imaging of the lumbosacral spine showed multilocular cystic and solid lesion with foci of calcification and subtle communication with spinal canal. Histopathological examination showed mature endodermal, ectodermal, and mesenchymal elements such as cartilage, glial tissues, keratin cyst, and glandular elements with focus of primary neuroepithelial and pancreatic elements. Entire tumor was excised. The baby expired secondary to wound infection. Early diagnosis by improving antenatal care with timely surgical intervention and good nursing care improves the outcome.

Büyük sakrokoksigeal teratomun prenatal tanısı ve takibi: Olgu sunumu

Büyük sakrokoksigeal teratomun prenatal tanısı ve takibi: Olgu sunumu

A Contrast Nephropathy in a Preterm Infant Following Preoperative Embolization of Giant Sacrococcygeal Teratoma

Newborn infants with huge and highly vascular sacrococcygeal teratoma (SCT) are frequently subjected to renal hypoperfusion secondary to high-output cardiac failure. Any underlying renal dysfunction is a significant risk factor for the development of contrast-induced nephropathy (CIN). However, reports on CIN in infants are rare. I report here a case of a premature infant born at 28 weeks and 3 days of gestation with a huge SCT who survived preoperative embolization and surgical resection but presented with persistent non-oliguric renal failure that was suggestive of CIN. During radiological intervention, a contrast medium had been administered at about 10 times the manufacturer-recommended dose for pediatric patients. Despite hemodynamic stabilization and normalization of urine output immediately following surgery, the patient’s serum creatinine and cystatin-C levels did not return to baseline until 4 months after birth. No signs of reflux nephropathy were observed in follow-up imaging studies. Dosing guidelines for the use of a contrast medium in radiological interventions should be provided for infants or young patients. Key words: Acute kidney injury; Contrast-induced nephropathy; Sacrococcygeal teratoma; Premature infant; Therapeutic embolization

Successful Postnatal Management of Ruptured Giant Sacrococcygeal Teratoma.

Most sacrococcygeal teratomas present between the 22nd and the 34th week of gestation. The diagnosis of sacrococcygeal teratoma on routine antenatal sonograms is associated with a greater than expected incidence of prenatal and perinatal complications. We report a premature baby with intrauterine spontaneous rupture of giant sacrococcygeal teratoma which was managed successfully.

Manejo prenatal del teratoma sacrococígeo, a propósito del primer caso sometido a transfusión sanguínea intrauterina en el Perú

El teratoma sacrococcígeo es una enfermedad rara en el feto, pero con alta mortalidad perinatal debido al secuestro de flujo sanguíneo y consiguiente desarrollo de anemia fetal severa. Presentamos el caso de una gestante de 27 semanas referida a nuestro servicio para manejo prenatal de un feto con teratoma sacrococcígeo gigante, que desarrolló anemia fetal severa y fue sometido a una transfusión intrauterina intravascular, la cual pudo prolongar el embarazo y mejorar los resultados perinatales.

Giant sacrococcygeal teratoma: Management concerns with reporting of a rare occurrence of venous air embolism.

Giant sacrococcygeal teratoma: Management concerns with reporting of a rare occurrence of venous air embolism.

Giant Sacrococcygeal Teratoma in New Born: Management of Two Cases in an Underdeveloped Country

Authors report their experience in management of two cases of giant sacrococcygeal teratomas in Ziguinchor Regional Hospital and emphasize the need for prenatal diagnosis and management before complications. Figure

Multi-stage resection and repair for the treatment of adult giant sacrococcygeal teratoma: A case report and literature review.

Sacrococcygeal teratoma (SCT) is a sacrococcygeal neoplasm derived from more than one primitive germ layer and is only occasionally encountered in adults. The primary treatment for all primary SCTs is surgical excision. The present study reports the case of a giant SCT in a middle-aged female with a history lasting >3 decades. Multi-staged surgical treatment was performed, including ileostomy plus tumor excision, four debridement plus flap repair procedures, and closure of the ileostomy. Follow-up showed improved quality of life without evidence of local recurrence after resection. The study also presents a brief overview of the relevant literature. To the best of our knowledge, this is the first report of multi-staged surgical treatment for giant SCT in an adult patient.

Successful cesarean delivery following prenatal diagnosis of giant sacrococcygeal teratoma in the fetus

Introduction: sacrococcygeal teratomas are the most common germ cell neoplasia in the newborn, which are seen on the frontal surface of coccyx and sacrum. As a result of ultrasonographic developments in recent years, sacrococcygeal teratoma can be easily diagnosed in the prenatal period. case report: We report a case of a 29 -year-old patient with a singleton pregnancy of 38 weeks, with a giant sacrococcygeal teratoma of 20x18 cm in the sacrococcygeal zone. the infant was successfully delivered by classical cesarean section. conclusion: It is quite important to diagnose sacrococcygeal teratomas in the early weeks of pregnancy and to monitor prenatal management and prenatal complications to be able to determine the mode and place of delivery. When planning delivery, the least traumatic method should be preferred.

Giant sacrococcygeal teratoma embolization

Resection of giant sacrococcygeal teratoma with high-vasculature in newborns can be a fatal procedure due to massive bleeding of the tumor. Endovascular embolization of the arteries that supply the tumor may lead to minimal blood loss. We present a case of giant high-vascular sacrococcygeal teratoma type-1 that was embolized in an infant born at 35 weeks gestation. This procedure lead to a safe, surgical resection with minimal bleeding: 12 ml.