Sacrococcygeal teratoma: A series of 19 cases with long-term follow-up

A series of 19 cases of sacrococcygeal teratoma (SCT) with follow-up of 5 t o 25 years is presented. Twelve patients were neonates, age 0 to 26 days (5 immature teratomas and 7 mature teratomas, representing 3, 6, 2, and 1 Alt man's type I, II, III, and IV tumors, respectively), four were infants, age 1 Po 6 months (all mature teratomas, representing 1, 1, and 2 Altman's typ e I, II, and IV tumors), and 3 were children, age 1 to 4 years (all maligna nt teratomas, all Altman's IV tumors). Eight babies were delivered by elect ive caesarean section (CS). Though the mean gestational age at CS was 34.3 weeks in our series. we now believe that CS often must be performed earlier , depending on a tumor size or fetal condition. Eleven neonates and 4 infan ts were operated upon using a sacral approach in 10 and an abdominosacral a pproach in 5, and all survived. However, 4 patients had neurogenic bladder and were treated by urinary catheterization or vesicostomy for 2 to 5 years after surgery. Postoperative urogenital sequelae are seen in patients with a large tumor, urethral compression, urinary retention. or edema of the lo wer body. Malignant tumors usually had metastasized by the time of diagnosi s. but the prognosis for outcome has been improved following surgery and co mbination chemotherapy.