Successful fetal sacrococcygeal teratoma resection in a hydropic fetus

Background/Purpose: The development of hydrops in a fetus with a sacroccocy geal teratoma (SCT) usually is a predictor of fetal demise; in utero resect ion may offer the only chance of survival. Although the authors had perform ed this procedure in 3 previous cases, they had no long-term patient surviv al. The authors report a successful case of in utero resection of a fetal s acrococcygeal teratoma. Methods: The authors resected a fetal SCT from a 23-weeks-gestation hydropi c fetus, using gradually tightening umbilical tapes at the tumor base, elec trocautery, a nd careful sharp dissection. After a blood transfusion, the f etus suffered cardiac arrest but was resuscitated and returned to the uteru s. Results: Postoperatively, residual SCT growth ceased, and hydrops rapidly r esolved. Five weeks after the procedure, the infant was delivered because o f preterm labor, and, after resection of residual SCT, was discharged home at 3 months of age. She is now a healthy 3 year old. Conclusion: This case shows that successful fetal SCT resection and long-te rm patient survival is possible. J Pediatr Surg 35:1489-1491. Copyright (C) 2000 by W.B. Saunders Company.