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2003, Number 2

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Acta Med 2003; 1 (2)

Sacrococcygeal teratoma: report of 20 cases

Gutiérrez UJA, Calderón ECA, Ruano AJM, Vásquez GE, Duarte VJC, Barraza LAR

Language: Spanish
References: 23
Page: 81-86
PDF size: 81.39 Kb.


ABSTRACT

Sacrococcygeal teratoma is the main extragonadal germinal neoplasm in childhood. It is usually detected in neonates, and has tendency to become malignant; thus, the importance of surgical treatment. Clinical histopathologic features, as well as surgical approach and disease-free were analyzed. This is a clinical, retrospective, observational study. Clinical charts of patients with diagnosis of sacrococcygeal tumor seen at this institution during 21 years were reviewed; sex, age, size of tumor, and clinical features were included. These were classified based on histopathologic diagnosis, treatment, and disease free survival. There were 20 patients (six boys and 14 girls in a 1:2.3 ratio); aged 1 day to 14 years. The main positive manifestation was increase of volume in 18 (90%). The teratoma was mature in 15 cases (75%) and immature in five (25%); one mature teratoma became malignant. Resection of the tumor was done by means of coccygectomy in 75% of patients. Disease-free survival was 100%; there was no trans or postoperative mortality. Risk of malignant transformation in mature teratomas is 5%. Complete resection of the tumor is an elective therapy and surveillance with tumor markers is necessary.


REFERENCES

  1. Altman RP, Randolph TG, Lilly JR. Sacrococcygeal teratoma: American Academy of Pediatrics Surgical Section Survey 1973. J Pediatr Surg 1974; 9: 389-398.

  2. Carney JA, Thompson DP, Johnson CL, Lynn HB. Teratomas in children: Clinical and Pathologic Aspects. J Pediatr Surg 1972; 7: 271-282.

  3. Flake AW, Harrison MR, Adzick US, Laberge JM, Warsof SL. Fetal Sacrococcygeal teratoma. J Pediatr Surg 1986; 21: 563-566.

  4. Keslar PJ, Buck JL, Suarez ES. Germ cell tumor of the sacrococcygeal region: Radiologic pathologic correlation. Radiographics 1994; 14: 607-620.

  5. Mahour GH, Woolley MM, Trived SN, Landing BH. Teratomas in infancy and childhood: experience with 81 cases. Surgery 1974; 2: 309-318.

  6. Billik R, Shandling B, Pope M, Thorner P, Weitzman S, Ein SH. Malignant benign neonatal sacrococcygeal teratoma. J Pediatr Surg 1993; 28: 158-160.

  7. Gross RE, Clatworthy A, Meeker IA. Sacrococcygeal teratomas in infants and children. Surg Gynecol Obstet 1951; 92: 341-354.

  8. Morales RR, Calderón EC, Ruano AJ, Palacios AJ, De León BB, Mora TM, Peralta BA. Teratoma sacrococcígeo. Estudio de 12 casos. Acta Pediatr Mex 1997; 18: 157-161.

  9. Sharma AK, Sharma CS, Gupta AK, Sarin YK, Agarwal LD, Zaffar M. Teratomas in pediatric age group: Experience with 75 cases. Indian Pediatrics 1993; 30: 689-694.

  10. Lindahl H. Giant Sacrococcygeal teratoma: A method of simple intraoperative control of hemorrhage. J Pediatr Surg 1998; 33: 1068-1069.

  11. Schmidt KG, Silverman N, Harrison MR, Callen P. High output cardiac failure in fetuses with large sacrococcygeal teratoma: Diagnosis by echocardiography and Doppler ultrasound. J Pediatr 1989; 114: 1023-1028.

  12. Bond SJ, Harrison MR, Schmidt K, Silverman N, Flake AW, Slotnik N et al. Death due to high output cardiac failure in fetal sacrococcygeal teratoma. J Pediatr Surg 1990; 25: 1287-1291.

  13. Walton JM, Rubin SZ, Soucy P, Benzie R, Ash K, Nimrod C. Fetal tumor associated with hidrops The role of the pediatric surgeon. J Pediatr Surg 1993; 28: 1151-1153.

  14. Inohue M, Kubota A, Hasegawa T, Hata S et al. Antenatal diagnosis of sacrococcygeal teratoma with hydrops fetalis: A case report. Eur J Pediatr Surg 1994; 29: 125-127.

  15. Teitenbaum D, Teich S, Cassidy S, Karp M, Cooney D, Besner G. Highly vascularized sacrococcygeal teratoma: description of the atypical variant and its operative management. J Pediatr 1989; 114: 1023-1028.

  16. Calderón EC, Ruano AJ, De León B, Hernández PJ, Morales RR, Palacios AJ, Peralta BA. Teratoma sacrococcígeo. Una urgencia quirúrgica neonatal. Acta Pediatr Mex 1996; 17(5): 249-253.

  17. Braun RG, Calderón EC, Ruano AJ. Biopsia por aspiración con aguja delgada en pediatría. Acta Pediatr Mex 1996; 17(4): 203-208.

  18. Ein SH, Mancer K, Adeyemi SD. Malignant sacrococcygeal teratoma-endodermal sinus, yolk sac tumor in infants and children: a 32 year review. J Pediatr Surg 1985; 20: 473-477.

  19. Waldhausen JA, Kolman TW, Vellios F et al. Sacrococcygeal teratoma. Surgery 1963; 54: 933-949.

  20. Roth A. Un tumeur renal inhabituelle, un teratome une dysplasie kistique, a un hypertension artierelle et a une secretion de alpha fetoprotein. J Urol 1984; 90: 7-10.

  21. Tsuchida V, Endo V, Saito S, Kaneko M, Shiraki K, Ohmi K. Evaluation of Alpha-Fetoprotein in early infancy. J Pediatr Surg 1978; 13: 155-62.

  22. Schropp KP, Lobe ET, Rao B, Mutabagani K, Kay GA, Gilchrist BF, Philippe PG, Boles ET. Sacrococcygeal teratoma: the experience of four decades. J Pediatr Surg 1992; 27: 1075-1079.

  23. Ablin A, Isaacs H. Germ cell tumor. In: Pizzo PA (editor). Pediatric Oncology. Philadelphia. PA, USA: J.B Lippincott Co. 1989: 713-731.




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