Sacrococcygeal teratoma: an experience from a high-volume tertiary institute in North India

Ajay Jhalani; Vinita Chaturvedi; Neeraj Tuteja; Atul K. Khare

doi:10.18203/2349-3291.ijcp20240725

Authors

Ajay Jhalani Department of Pediatrics Surgery, SMS Medical College, Jaipur, Rajasthan, India
Vinita Chaturvedi Department of Pediatrics Surgery, SMS Medical College, Jaipur, Rajasthan, India
Neeraj Tuteja Department of Pediatrics Surgery, SMS Medical College, Jaipur, Rajasthan, India
Atul K. Khare Department of Pediatrics Surgery, SMS Medical College, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20240725

Keywords:

Sacrococcygeal teratoma, Tumour, Fecal incontinence, Exploratory laparotomy, Complications, Malignancy

Abstract

Background: Sacrococcygeal teratoma (SCT) is the most common tumour in the newborn. The majority is present in neonates as a sacral mass; however, some may be present late with varied clinical presentation. The study aims to evaluate the clinical presentation and management of patients with SCT in our high-volume tertiary institute in North India.

Methods: This is an observational study of infants and children treated between May 2021 to April 2022 in the department of pediatric surgery, SMS Medical College, Jaipur (a high-volume tertiary institute in North India). Data collected included antenatal diagnosis, mode of delivery, age at diagnosis, clinical presentation, Altman classification, surgical approach, histopathology and complications. Functional results were evaluated clinically and radiologically.

Results: Twenty-one patients (M: F=1:3.2) with a median age of 40 days (range: 1 day to 5.8 years) with SCT were managed at our centre. Nearly, two-thirds of the tumors were either Altman type 1 or 2. Yolk sac tumour was present in 2 (9.5%) patients, while the rest had either mature or immature teratoma. Tumours were removed through a posterior sagittal approach (chevron incision). In five patients, an abdominoperineal approach was used. Early complications were surgical site infection (n=5; 23.8%), superficial wound dehiscence (n=2; 9.5%), complete wound dehiscence (n=1; 2.4%), and urinary tract infection (n=1; 4.7%). Late complications were urinary dribbling or poor stream (5/21; 23.8%) and faecal soiling (n=3; 14.2%).

Conclusions: Most of the sacrococcygeal tumours are benign, and the incidence of malignancy increases with age. Morbidity due to associated malformation and treatment may persist in these patients, especially like urinary complications stream (one-fifth) and faecal incontinence (one-seventh), as seen in our series. A proper long-term follow-up is needed for the management of late complications.

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