Discussion of Sacrococcygeal teratoma
- Sacrococcygeal teratoma is the most common congenital neoplasm, occurring in one in 40,000 infants.
- Approximately 75% of affected infants are female.
- The tumor is derived from the pluripotential cell line and contains components arising from all three germ layers.
- Fetal sacrococcygeal teratomas diagnosed in utero carry a high risk of preterm delivery (50%), a mortality rate of 15-35%, and a morbidity rate of 12-68%.
- The perinatal mortality and morbidity rates are high because of high output cardiac failure, preterm delivery, anemia, dystocia, and tumor rupture.
- The intrapelvic and intraabdominal extent of the sacrococcygeal teratoma and its compressive effect on the urinary tract also affect perinatal morbidity.
- Sacrococcygeal teratomas can grow at a very rapid rate and reach enormous volumes, which can approach and even eclipse the volume of the fetus itself.
- Prognosis seems to be related not to the size of the mass but rather to its content and extent. Solid hypervascularized masses carry a poorer prognosis than purely cystic masses.
 Imaging Findings for Sacrococcygeal teratoma
- The sonographic appearance of a sacrococcygeal teratoma is typically that of a heterogeneous, mixed cystic and solid mass. The tumors may be purely cystic in 15% of cases.
- Interrogation with Doppler US is essential to evaluate tumor vascularity.
- The fetal spine should be meticulously evaluated for defects, as a myelomeningocele is the primary differential diagnosis. In addition, a sacrococcygeal teratoma may involve the spinal canal.
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 References for Sacrococcygeal teratoma
- Avni, Fred E., Guibaud, Laurent, Robert, Yann, Segers, Valerie, Ziereisen, France, Delaet, Marc-Henri, Metens, Thierry. MR Imaging of Fetal Sacrococcygeal Teratoma: Diagnosis and Assessment. Am. J. Roentgenol. 2002 178: 179-183.
- Paula J. Woodward, Roya Sohaey, Anne Kennedy, and Kelly K. Koeller. From the Archives of the AFIP: A Comprehensive Review of Fetal Tumors with Pathologic Correlation. RadioGraphics 2005 25: 215-242.