Sacrococcygeal teratoma: management and outcomes

Abstract

Background/aim Sacrococcygeal teratomas are the most common tumor during the neonatal period. They are either benign (mature) or malignant (immature, composed of embryonic elements). This retrospective study aims at reviewing our experience in management and outcome of this pathology during the period from January 2008 to November 2013.
Patients and methods Charts were designed to collect the following data: the age at presentation, sex, clinical presentation, associated anomalies, Altman’s classification, investigations, management modality, tumor histology with respect to type and resection margins, outcome of treatment, and bowel or urinary complications.
Results A total of 20 patients were included in this study. There were six male patients and 14 female patients. Ten patients were Altman type I, seven were type II, one was type III, and two were type IV. Surgical intervention was carried out using a posterior sacral approach in 17 patients (all type I and II patients) or combined abdominal and posterior sacral approaches in the remaining three patients (types III and IV). Recurrence occurred in two patients; these were types III and IV. We had one mortality. Two patients reported involuntary bowel movements, two reported frequent soiling, and five reported constipation.
Conclusion Awareness about this pathology among practitioners is essential and would have avoided complications in this series. Early diagnosis and complete excision with removal of the coccyx is associated with good prognosis. Recurrence is related to tumor spillage during excision. Long-term lower gastrointestinal problems (constipation, fecal soiling) correlate with Altman’s classification of the tumor.

Keywords: Altman’s classification, sacrococcygeal teratoma, Teratomas