Sacrococcygeal Teratoma: Management and Outcomes

Background/Purpose: Sacrococcygeal teratoma (SCT) is a relatively uncommon tumor affecting neonates, infants, and children. This study was designed to determine the various patterns of clinical presentation, and factors affecting the outcome of patients with SCT. Materials & Methods: A total of 35 patients with SCT were received during the period from January 1998 to November 2008 at Tanta University Hospital and its affiliated hospitals. A retrospective review of all recorded data concerning maternal history, mode of delivery, age at presentation, patient sex, presenting clinical features, associated anomalies, various laboratory and radiological investigations, operative details, and tumor histopathology were performed. Early and late postoperative functional results and complications were also reviewed. The patients were divided into 2 groups according to the age at presentation. Group I involved 21 patients presented at the neonatal period, while group II included 14 patients presented after the first month of life. The follow up period ranged between 3 months and 8 years Results: One patient died prior to surgery. Excision of the tumors was achieved in the remaining 34 patients. Living patients in group I (n=20) were operated upon at a median age of 2 days. The histology proved to be benign in all patients in this group, and no recurrence was noted during a follow period ranging between 3 months and 8 years. The mean age at surgery was 6+ 3 months in group II patients (n= 14). In this group, three patients proved to have malignant changes in the excised specimens and postoperative recurrence occurred in 4 patients. Conclusion: A prenatal diagnosis of SCT is essential to avoid early mortality. This study stressed on the importance of early diagnosis, early complete en-block resection of the tumor along with the coccyx, and the avoidance of intraoperative spillage of the tumor as critical factors in prognosis. Delayed presentation and the presence of malignant changes continued to be poor prognostic factors. Close follow-up of these patients is mandatory to deal with the potential postoperative sequelae of surgery.