SACROCOCCYGEAL TERATOMA IN CHILDREN - A DIAGNOSTIC CHALLENGE

Sacrococcygeal teratoma is relatively rare. Its characteristic appeara nce, location and size usually leave little doubt as to the diagnosis, but the less obvious ones may occasionally give rise to diagnostic di fficulty. Four cases of sacrococcygeal teratoma in children are report ed. One neonate presented with a large protuberant swelling at the sac rococcygeal area, with no diagnostic difficulty. The second neonate pr esented with a small paraxial sacral swelling with an overlying haeman gioma. The third patient presented with a small tail-like appendage at the natal cleft. A properly performed rectal examination in both the second and third patients disclosed the diagnosis. The fourth patient presented with an anocutaneous fistula and partial sacral agenesis wit h no external sacrococcygeal swelling. The diagnosis was confirmed wit h computerized tomography. While the diagnosis of the protuberant sacr ococcygeal teratoma presents no difficulty, that of the less obvious c ases requires a high index of clinical suspicion. A properly performed rectal examination supplemented with appropriate imaging allows the d iagnosis to be made.