Radiofrequency ablation of human fetal sacrococcygeal teratoma

OBJECTIVE: Fetuses with solid, highly vascularized sacrococcygeal teratomas can die as a result of the vascular steal syndrome. This is the first repo rt in which a percutaneous technique, radiofrequency ablation, was used to interrupt blood flow to a sacrococcygeal teratoma in 4 human fetuses. STUDY DESIGN: A radiofrequency ablation probe was percutaneously inserted i nto the fetal tumor under ultrasonographic guidance. In 2 fetuses a signifi cant portion of the tumor mass was ablated, whereas in the other 2 fetuses only the major feeding vessels were targeted. RESULTS: Two infants were delivered at 28 and 31 weeks' gestation, respecti vely, and are doing well. In 2 other cases hemorrhage into the tumor led to an unfavorable fetal outcome. CONCLUSION: Ablation of a majority of the tumor tissue in sacrococcygeal te ratoma is not necessary and proved fatal in two instances. Targeted ablatio n of the feeding tumor vessels diminishes blood flow sufficiently to revers e high-output fetal heart failure.