Prenatal diagnosis of sacrococcygeal teratoma: analysis of a case series
DOI:
https://doi.org/10.15574/PS.2025.3(88).1925Keywords:
sacrococcygeal teratoma, prenatal diagnosis, ultrasound diagnostics, congenital malformationsAbstract
Aim - to characterize the data of pregnant women and the results of prenatal examinations in a case series of fetal sacrococcygeal teratoma, to determine typical anatomical variants and associated pathology.
Materials and methods. A retrospective analysis of the medical records of 32 pregnant patients who were diagnosed with sacrococcygeal teratoma in the fetus, and were examined in years 2013-2025. The most typical variants of tumor’s relative size and echo-structure were analyzed, as well as the rate of associated pathology, and the differences depending on the fetal sex and tumor size.
Results. Among 32 cases associated structural pathology was diagnosed in 15 (46.9%) fetuses, and was represented by malformations of other organs/systems, and by secondary local and systemic pathological changes due to teratoma. The mean maternal age was 27.9±6.1 years, the largest group was represented by women 25-29 years old (43.8%), the mean age of women with male fetuses was significantly higher than with female (32.3±6.7 and 26.5±5.5 years). Ultrasound features were highly variable, most often giant teratomas (40.6%) were diagnosed, tumors with solid-cystic and solid structure (43.8%), and type I according to Altman. Typical echo-structure in tumors of different sizes was characterized. Less than half of the patients (43.75%) were referred to the specialized department before 22 weeks of pregnancy, which is unsatisfactory for such a severe pathology.
Conclusions. Sacrococcygeal teratoma is a rare pathology that was most commonly diagnosed in fetuses of young women, was often associated with other malformations or led to secondary local and systemic pathological changes. Prenatally most severe anatomical variants were frequently diagnosed, such as giant teratomas, solid-cystic and solid tumors, which determines the importance of timely/early referral of pregnant women to specialized centers for further evaluation and optimal choice of management.
The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies.
References
Altman RP, Randolph JG, Lilly JR. (1974, Jun). Sacrococcygeal teratoma: American academy of pediatrics surgical section survey. J Pediatr Surg. 9(3):389-98. https://doi.org/10.1016/S0022-3468(74)80297-6; PMid:4843993
Ayed A, Tonks AM, Lander A, Kilby MD. (2015). A review of pregnancies complicated by congenital sacrococcygeal teratoma in the West Midlands region over an 18-year period: population-based, cohort study. Prenatal diagnosis. 35(11): 1037-1047. https://doi.org/10.1002/pd.4641; PMid:26114890
Chen-Carrington A, Leonard D, Goodreau A, Rhodes J, Tye GW. (2024). Prenatal diagnosis of meningomyelocele resolves as a mature cystic teratoma in the thoracolumbar region. Child's nervous system. 40(8): 2593-2598. https://doi.org/10.1007/s00381-024-06396-7; PMid:38684568 PMCid:PMC11269449
Creden SP, Portuondo J, Cheng LS, Halaweish I, Keswani SG, King AL et al. (2023). Approach and Technique for Cesarean Section to Immediate Resection for High-Risk Sacrococcygeal Teratomas. The Journal of surgical research. 292: 38-43. https://doi.org/10.1016/j.jss.2023.07.021; PMid:37579714
Danzer E, Hubbard AM, Hedrick HL, Johnson MP, Wilson RD, Howell LJ et al. (2006). Diagnosis and characterization of fetal sacrococcygeal teratoma with prenatal MRI. AJR. American journal of roentgenology. 187(4): W350-W356. https://doi.org/10.2214/AJR.05.0152; PMid:16985105
Gonzalez-Crussi F. (1982). Extragonadal Teratomas. Atlas of Tumor Pathology. 2nd Edition, Armed Forces Institute of Pathology, Washington DC.
Gucciardo L, Uyttebroek A, De Wever I, Renard M, Claus F, Devlieger R et al. (2011). Prenatal assessment and management of sacrococcygeal teratoma. Prenatal diagnosis. 31(7): 678-688. https://doi.org/10.1002/pd.2781; PMid:21656530
Hodek B, Pavleković I, Pirkić A. (1976, Feb). Antenatal diagnosis by means of ultrasound in the rare case of foetal parasitic tumor. Z Geburtshilfe Perinatol. 180(1): 91-94. PMID: 773017.
Lynch SA, Wang Y, Strachan T, Burn J, Lindsay S. (2000). Autosomal dominant sacral agenesis: Currarino syndrome. Journal of medical genetics. 37(8): 561-566. https://doi.org/10.1136/jmg.37.8.561; PMid:10922380 PMCid:PMC1734652
Mandelbaum AD, Sun RC, Kim AJH, Sohaey R, Hakar M, Tavoosi S et al. (2024). Pregnancy and Long-Term Postnatal Outcomes of Congenital Sacrococcygeal Teratoma: A Single Institution's 18-Year Experience. Birth defects research. 116(10): e2405. https://doi.org/10.1002/bdr2.2405; PMid:39425502
Oosterhuis JW, Looijenga LHJ. (2019). Human germ cell tumours from a developmental perspective. Nature reviews. Cancer. 19(9): 522-537. https://doi.org/10.1038/s41568-019-0178-9; PMid:31413324
Pauniaho SL, Heikinheimo O, Vettenranta K, Salonen J, Stefanovic V, Ritvanen A et al. (2013). High prevalence of sacrococcygeal teratoma in Finland - a nationwide population-based study. Acta paediatrica, 102(6): e251-e256. https://doi.org/10.1111/apa.12211; PMid:23432104
Phi JH. (2021, May). Sacrococcygeal Teratoma: A Tumor at the Center of Embryogenesis. J Korean Neurosurg Soc. 64(3): 406-413. Epub 2021 Apr 29. https://doi.org/10.3340/jkns.2021.0015; PMid:33906346 PMCid:PMC8128526
Sand H, Bock JE. (1976). Prenatal diagnosis of soft-tissue malformations by ultrasound and X-ray. Acta Obstet Gynecol Scand. 55(3): 191-199. https://doi.org/10.3109/00016347609156912; PMid:936982
Shibui Y, Obata S, Hirose R, Nakano R, Setoue T, Miyazaki T et al. (2023). A case of sacrococcygeal teratoma associated with antenatally acquired urethrovaginal fistula and hydrocolpos. Surgical case reports. 9(1): 191. https://doi.org/10.1186/s40792-023-01772-y; PMid:37903968 PMCid:PMC10616020
Sliepov OK, Perederii OV, Grebinichenko GO, Skrypchenko NY. (2024). The importance of prenatal diagnosis and examination in the perinatal care of fetuses and newborns with sacrococcygeal teratomas. Ukrainian Journal of Perinatology and Pediatrics. 2(98): 60-69. https://doi.org/10.15574/PP.2024.98.60
Sliepov OK, Perederii OV, Skrypchenko NY, Kotsovsky VV, Hladyshko OP, Grebinichenko GO. (2023). The first intravital case of diagnosis and treatment of a giant teratoma of the sacrococcygeal area, which exceeded the body weight of a newborn on 1.5 times. Paediatric Surgery (Ukraine). 3(80): 92-99. https://doi.org/10.15574/PS.2023.80.92
Spingler T, Wiechers C, Lieber J, Kagan KO. (2023). Exceptionally early diagnosis of fetal sacrococcygeal teratoma in first trimester ultrasound. Archives of gynecology and obstetrics. 308(1): 301-303. https://doi.org/10.1007/s00404-022-06721-y; PMid:35922608 PMCid:PMC10192175
Statile CJ, Cnota JF, Gomien S, Divanovic A, Crombleholme T, Michelfelder E. (2013). Estimated cardiac output and cardiovascular profile score in fetuses with high cardiac output lesions. Ultrasound in obstetrics & gynecology. 41(1): 54-58. https://doi.org/10.1002/uog.12309; PMid:23001941
Tongsong T, Wanapirak C, Piyamongkol W, Sudasana J. (1999). Prenatal sonographic features of sacrococcygeal teratoma. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 67(2): 95-101. https://doi.org/10.1016/S0020-7292(99)00118-6; PMid:10636053
Van Heurn LJ, Coumans ABC, Derikx JPM, Bekker MN, Bilardo KM, Duin LK et a. (2021). Factors associated with poor outcome in fetuses prenatally diagnosed with sacrococcygeal teratoma. Prenatal diagnosis. 41(11): 1430-1438. https://doi.org/10.1002/pd.6026; PMid:34327722 PMCid:PMC9292788
Van Heurn LJ, Coumans A, Haak MC, van der Kaaij A, van Heurn LWE et al. (2023). Prognostic accuracy of factors associated with poor outcome in prenatally diagnosed sacrococcygeal teratoma: A systematic review and meta-analysis. Prenatal diagnosis. 43(12): 1495-1505. https://doi.org/10.1002/pd.645; PMid:12868086
Vinit N, Benachi A, Rosenblatt J, Jouannic JM, Rousseau V, Bonnard A et al. (2024). Growth velocity of fetal sacrococcygeal teratoma as predictor of perinatal morbidity and mortality: multicenter study. Ultrasound in obstetrics & gynecology. 64(5): 651-660. https://doi.org/10.1002/uog.29110; PMid:39482803
Zaninovic AC, Westra SJ, Hall TR, Sherman MP, Wong L, Boechat MI. (1992). Congenital bladder rupture and urine ascites secondary to a sacrococcygeal teratoma. Pediatric radiology. 22(7): 509-511. https://doi.org/10.1007/BF02012995; PMid:1491908
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