Primary Diagnosis

Sacrococcygeal Teratoma.

Secondary Diagnosis

N/A

Diagnosis Discussion

The four images provided are obtained from two different fetuses with the same condition; a sacrococcygeal teratoma. Sacrococcygeal teratoma usually present as a mass protruding between the coccyx and the rectum, nearly always arising from the tip of the coccyx. Benign teratomas usually produce no functional impairment. 15% of patients have associated congenital anomalies like imperforate anus, sacral bone defects, duplication of uterus or vagina, spina bifida, meningomyelocele. The tumor markers are AFP and b -HCG. In contrast to the SCT in infancy, presacral teratoma in adult are extremely rare. The presence of a teratoma in the fetus may be accompanied by polyhydramnios, a uterine size larger than the expected gestational age, elevated levels of alpha-fetoprotein in amniotic fluid and associated with increased risk of - stillbirths, fetal hydrops, high output cardiac failure presumably as a result of vascular shunting through the tumour. Neonatal sacrococcygeal teratoma is a rare tumor and it being potentially malignant tumor the early diagnosis helps in management. The diagnostic imaging studies help to confirm the diagnosis of a clinically palpable sacrococcygeal mass, determine its relationship to other structures and detect metastases. Although in our case it was an intrauterine fetal demise but neonatal sacrococcygeal teratomas can be associated with a very good prognosis by utilizing prenatal diagnosis, proper intrapartum management, detailed neonatal preoperative delineation, and complete surgical excision of the tumor.

General Anatomic Area:

Sacrum and Coccyx

Secondary Anatomic Area:

N/A

Disease Category:

Congenital

Contributor:

Erin Simon, MD

Date:

01/01/2006

Difficulty Level:

Medium

Pathology Confirmed?:

Yes
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ACR Category Number:

N/A

Keywords:

neoplasia, lipoma, teratoma,dermoid