Outcome of antenatally diagnosed sacrococcygeal teratomas: single-center experience (1993-2004).

Abstract

AIMS:

Sacrococcygeal teratomas (SCTs) are the commonest neonatal tumors with an incidence of approximately 1:30,000. There are few large single-center series and even fewer describing both their antenatal and postnatal course. We report the outcome of all fetuses investigated at a tertiary fetal medicine center with this diagnosis.

METHOD:

Demographic details were obtained from a prospectively maintained database. Patient records were examined for additional data including antenatal and postnatal interventions. Data were described as median (range).

RESULTS:

Forty-one SCTs were diagnosed antenatally during the period 1993 to 2004. Twelve were excluded from subsequent analysis (single antenatal visit or attending for second opinion [n = 6] and termination of pregnancy [n = 6]). Twelve underwent fetal intervention (laser vessel ablation [n = 4], alcohol sclerosis [n = 3], cyst drainage [n = 2], amniodrainage [n = 2], vesicoamniotic shunt [n = 1]) for fetal hydrops and polyhydramnios to aid in delivery and to prevent obstructive uropathy developing in the fetus. Of these, 3 died in utero and 9 survived to be born (median gestational age, 33 weeks [27-37 weeks]). A further 3 died in the neonatal period. There are 6 long-term survivors (50%) from this group. Seventeen infants, without intervention, were born at median gestational age 38 weeks (26-40 weeks). One infant with severe cardiac anomalies died on the day of birth. All surviving infants had definitive excisional surgery at a median of 2 days (1-16 days). Current median follow-up of survivors is 39 months (8-86 months). There have been no recurrences. One child has mild constipation, and 3 are awaiting cosmetic revision of their scars.

CONCLUSIONS:

The overall survival of antenatally diagnosed SCT is approximately 77%, with the development of hydrops and others requiring in utero intervention carrying a poor prognosis. Otherwise, the outcome after surgical excision is excellent.

• Authors: Erica C Makin, Jon Hyett, Niyi Ade-Ajayi, Shailesh Patel, Kypros Nicolaides, Mark Davenport
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 41 Issue 2 Pg. 388-93 (Feb 2006) ISSN: 1531-5037 [Electronic] United States
• PMID: 16481257 (Publication Type: Journal Article)

Topics

• Adult
• Female
• Humans
• Infant, Newborn
• Middle Aged
• Pregnancy
• Retrospective Studies
• Sacrococcygeal Region
• Teratoma (diagnostic imaging, surgery)
• Treatment Outcome
• Ultrasonography, Prenatal