Sacrococcygeal teratoma

Abstract

Sacrococcygeal teratoma is the most common congenital neoplasm in fetuses and neonates. It originates from the presacral space and is classified according to the degree of intra- and extra-pelvic tumor. SCTs are also classified according to the presence of a solid or cystic tumor component. Solid SCTs are more vascular and are at an increased risk of causing high-output cardiac failure in utero and tumor hemorrhage either pre- or postnatally with disastrous consequences. Advances in prenatal care have allowed for the diagnosis of the majority of SCTs prior to birth. Postnatal evaluation includes MRI or CT scan to evaluate the extent of the tumor and evaluation of tumor markers (AFP, βHCG). Complete surgical resection provides the only cure and long-term follow-up is required due to a risk of recurrence that approaches 15 %. The SCT with a large intrapelvic component has an increased risk of long-term urologic and anorectal complications, which also mandates continued follow-up. A small subset of high-risk large fetal SCTs are candidates for fetal intervention including tumor debulking. Overall survival of patients with an SCT following complete resection without recurrence is >90 %.