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What is Sacrococcygeal Teratoma

Sacrococcygeal Teratoma

What is Sacrococcygeal Teratoma?

Sacrococcygeal Teratoma

Figure. Sacrococcygeal Teratoma 

Sacrococcygeal Teratoma is the Teratoma of the Tailbone. Teratoma means a tumor made up of several different tissues like bone, skin, hair or muscle typically occurring in the testicle, ovary or tailbone.

How it looks?
Fetal SCT may be completely internal –
may push and displace other oragns internally.
At Birth – visible lump or mass under skin top of the buttock crease (can be seen in the picture). It feels like a hard boiled egg.

  • What are the other tumors developed at the Sacrococcygeal region?
  • extraspinal ependymoma,
  • ependymoblastoma,
  • neuroblastoma and
  • rhabdomyosarcoma.

Important Points:

  • The most commonly diagnosed fetal teratomas are sacrococcygeal teratoma
  • Sacrococcygeal Teratoma is developed from Primitive Streak
    It is mostly occur in children (female>male)
  • In prenatal Ultrasound external component is found to be cyst filled cavity.
  • Most of the internal SCT is not detected even when it is large and cover most of the pelvis as Bony pelvis conceals it from detection. Displacement of pelvic organ like urinary bladder helps in detection.

So the preferred tretment of SCT is surgery.
If the SCT is small we should approch through the perineum. In case of large, we should also approch through the abdomen.
Usually resection of the coccyx and some part of the sacrum is needed. So, muscles and ligaments attached to those part should be reattached i.e. reconstruction of the posterior perineum is required. If it is not done it may lead to peritoneal hernia.
if coccyx is not removed it causes recurrence of teratoma and metastatic cancer.

  • Types of SCT?
    There are 4 types of SCT on the basis of extent of the tumor inside or outside the body.
  • Altman type I — entirely outside,
  • Altman type II — mostly outside
  • Altman type III — mostly inside
  • Altman type IV — entirely inside;

Significance of the Altman typing is that more the tumor remains outside the body, labour and delivery gets more complicated.

Altman type can change over time.

  • Complications
    Complication in mother
  • During pregnancy – Mirror syndrome
  • During Delivery – Cesarean Section / Mechanical Dystocia

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