YOLK-SAC TUMOR IDENTIFIED AT AUTOPSY AFTER SURGICAL EXCISION OF IMMATURE SACROCOCCYGEAL TERATOMA

Although the predictive value of immature elements in sacrococcygeal t eratomas is unclear, there are reports of malignant recurrence after s urgical resection of immature sacrococcygeal teratomas. The recurrent tumors are presumed to arise from small residual malignant foci not id entified fled at the time of surgical resection. In this report a prem ature female infant was delivered at 29 weeks' gestation with a large sacrococcygeal teratoma. The tumor weighed 1.350 g. It was largely cys tic with a focal nodular and variegated appearance. Histologically, th e tumor was a grade 1 immature teratoma with a predominance of neurogl ial elements. No malignant elements were identified in any of 26 secti ons examined. The infant died intraoperatively of cardiovascular compl ications related to the large vascular Supply of the tumor but had a g rossly complete resection of tumor. At autopsy, a Small microscopic fo cus of yolk sac tumor was identified adjacent to the sacrum anteriorly . Had the infant survived, this focus might well have been a source fo r malignant recurrence. Copyright (C) 1995 by W.B. Saunders Company