Prenatal Diagnosis Of Sacrococcygeal Teratoma Research Articles

Neonatal sacrococcygeal teratoma: Our 20-year experience from a tertiary care centre in North India.

Advances in diagnostic and therapeutic interventions have improved the survival of neonates with sacrococcygeal teratoma in richer countries. These changes have not yet taken place in resource-limited settings. A retrospective analysis of neonates with sacrococcygeal teratoma operated at our centre during 1997-2016 was performed. Among 44 neonates enrolled, prenatal diagnosis of sacrococcygeal teratoma was available in 25% of pregnancies. All babies except one were born vaginally. Associated congenital malformations were seen in 20% (9/44). Types of sacrococcygeal teratoma were classified as Altman type I in 12 (27.3%), 24 (54.5%) as type II, 6 (13.6%) as type III and 2 (4.5%) as type IV. Morphologically, 77% (34/44) neonates had cystic lesions. All patients were managed successfully by total excision. Histopathology confirmed mature teratoma in 43 (97.7%). After a 12-month follow-up, no recurrence was observed. An uneventful pregnancy, absence of associated congenital anomalies, cystic morphology and a mature histology are good prognostic factors.

Evaluation of prenatally diagnosed fetal sacrococcygeal teratomas: A case series of seventeen pregnancies from South-central Turkey.

Objective:To evaluate sacrococcygeal teratoma (SCT) cases according to associated cardiac, extracardiac, and chromosomal anomalies in the prenatal period, and to review their outcomes.Materials and Methods:Data of pregnancies with a prenatal diagnosis of SCT between 2009 and 2019 were retrospectively reviewed.Results:One ongoing pregnancy was excluded. There were five medically terminated cases, three due to severe heart failure and the remaining two due to additional congenital defects. Two infants who had heart failure due to hyperdynamic flow died in the neonatal period. Nine infants are well and alive at the time of writing.Conclusion:When a lesion is detected in the sacrococcygeal region during fetal sonography, the differential diagnosis should be made with an appropriate evaluation with emphasis on a possible diagnosis of fetal SCT. Tumor growth and heart failure should be monitored with serial scans when SCT has been diagnosed prenatally.

Ultrasound and magnetic resonance imaging in prenatal diagnosis of sacrococcygeal teratoma: Case report

Fetal tumors are relatively rare and the early prenatal diagnosis enables the prediction of possible complications and decision for appropriate treatment. This paper deals with the role of ultrasonography and magnetic resonance imaging in the early prenatal diagnosis of sacrococcygeal teratoma. A 21-year-old primigravida was found to have a large sacrococcygeal tumor measuring 25 x 30mm, presented mainly as a solid mass, when she underwent the initial ultrasound examination on the first day of 19th week of gestation. There were no other associated anomalies. The second ultrasound examination was obtained after 6 days and revealed that the tumor had doubled its size. The prominent enlargement raised suspicion of immature sacrococcygeal teratoma and thus, fetal magnetic resonance imaging was performed in the 20th gestation week. The examination showed a crococcygeal teratoma presented as a large solid mass with small microcystic areas, the largest diameter being 60mm, completely externally positioned with no intra-pelvic extension. Rapid tumor growth posed a threat to the fetal circulation and it was the main reason when opting for the termination of pregnancy at 20 weeks of gestation. Pathohystological examination confirmed the diagnosis of immature sacrococcygeal teratoma. In the prenatal period the magnetic resonance imaging of a fetal tumor initially diagnosed by ultrasound examination is an additional part of diagnostic procedure, and it is not contraindicated during pregnancy. Magnetic resonance imaging improves the delineation of the tumor. The prompt prenatal diagnosis of sacrococcygeal teratoma, as well as the detection of possible associated anomalies, is important for the pregnancy management, prediction of possible complications and choice of appropriate treatment. Ultrasonography and magnetic resonance imaging are noninvasive, compatible and complementary diagnostic modalities in evaluation of sacrococcygeal teratoma in prenatal period.

Prenatal and postnatal urologic complications of sacrococcygeal teratomas

Purpose Urologic complications are an underappreciated sequelae of the mass effect of sacrococcygeal teratoma (SCT) and its resection. The goal of this study was to evaluate the incidence and severity of urologic complications in patients with SCT. Methods A retrospective review of patients with a prenatal diagnosis of SCT and postnatal referral for SCT at a single institution during a 5-year period (2004-2009) was performed. The presence of prenatal and postnatal urologic abnormalities were collected and analyzed. Results Thirty patients were identified for inclusion in the study. Twenty-two patients were diagnosed prenatally, 3 patients were referred for resection of the tumor, and 5 patients were initially treated elsewhere and referred after resection for urologic complications. Of the 20 patients with subsequent follow-up included in this study, 9 had neurogenic bladder, 5 of whom also had associated renal injury. All patients with renal injury had a higher grade Altman type II/III lesion. Conclusion Urologic problems appear to be common in patients with SCT. Higher grade SCTs should alert the surgeon to possible urologic sequelae, particularly neurogenic bladder and renal injury. Careful urologic evaluation and management of the genitourinary tract should be included in prenatal and preoperative counseling.

ALPHA-FETOPROTEIN FOLLOWING NEONATAL RESECTION OF SACROCOCCYGEAL TERATOMA

The sacrococcygeal teratoma (SCT) is the most frequent tumor in the neonatal period. Alpha-fetoprotein (AFP) levels fall after tumoral resection, although the time required for level normalization has not been established. The authors evaluate the time required for AFP levels to reach normal levels in 6 infants with prenatal diagnosis of SCT who underwent surgery for resection. The mean time required for AFP level normalization was 9 months. All patients were alive and 1 had neurogenic bladder. AFP has a progressive decrease, which may last 9 months in average and should not be confused with tumoral relapse.

Prenatal sonographic features of sacrococcygeal teratoma

Objective: To describe the potential role of ultrasound in prenatal diagnosis of fetal sacrococcygeal teratoma (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.

Meconium pseudocyst presenting as a buttock mass

A newborn 2.4-kg baby girl with a prenatal diagnosis of sacrococcygeal teratoma by ultrasound had a soft cystic mass extending from the infracoccygeal region into the right buttock. The cyst contained meconium leading to a large retroperitoneal cavity. The cyst was drained through an extended buttock incision, and healed without a site of bowel perforation ever identified. Meconium pseudocyst should be included in the differential diagnosis of sacrococcygeal and buttock tumors in the newborn.