The natural history of sacrococcygeal teratomas diagnosed through routine obstetric sonogram: A single institution experience

• Published in: Journal of pediatric surgery Vol. 33; no. 6; pp. 899 - 903
• Main Authors: Holterman, Ai-Xuan, Filiatrault, Denis, Lallier, Michel, Youssef, Sami
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.06.1998; Elsevier
• Subjects: Biological and medical sciences; Female; Fetal Diseases - diagnostic imaging; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Male; Management. Prenatal diagnosis; Medical sciences; Pregnancy; Pregnancy Outcome; Pregnancy. Fetus. Placenta; Prognosis; Retrospective Studies; Sacrococcygeal Region; Teratoma - diagnostic imaging; Ultrasonography, Prenatal; polyhydramnios; fetal outcome; Fetal sacrococcygeal teratoma; sonographic diagnosis; Sonography; Human; Prenatal; Fetal diseases; Teratoma; Pregnancy disorders; Echography; Tumor; Fetus; Diagnosis; Sacrococcygeal
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/S0022-3468(98)90670-4

Background/Purpose: The antenatal diagnosis of sacrococcygeal teratoma (SCT) is increasingly being made with fetal sonography. However, the natural history of SCT detected on routine obstetric sonogram is not well defined. Methods: A retrospective chart review of 21 fetal SCT diagnosed on routine sonography at Hospital Sainte-Justine between 1980 and 1997 were performed. The patients' clinical and sonographic characteristics, prenatal, and perinatal outcomes were examined. Prognostic criteria were identified by correlating patients' characteristics with outcome. Results: In utero mortality rate was 19% and perinatal mortality rate was 14%. The incidence of premature labor was 50%. Of the various criteria examined as an independent variable, the presence of a solid tumor was found to be a important negative prognostic factor with a 67% incidence of death in utero and an overall mortality rate of 100%. Patients with new onset polyhydramnios were at significant risks for premature labor (100%). All of the perinatal deaths were attributable to tumor rupture. Conclusions: The course of sacrococcygeal teratoma diagnosed on routine sonograms is associated with a higher-than-expected incidence of prenatal and perinatal complications. Close antenatal follow-up for new onset polyhydramnios and the presence of a completely solid tumor will help optimize patient counseling and treatment.