Successful fetal sacrococcygeal teratoma resection in a hydropic fetus.
OBJECTIVE
The development of hydrops in a fetus with a sacroccocygeal teratoma (SCT) usually is a predictor of fetal demise; in utero resection may offer the only chance of survival. Although the authors had performed this procedure in 3 previous cases, they had no long-term patient survival. The authors report a successful case of in utero resection of a fetal sacrococcygeal teratoma.


METHODS
The authors resected a fetal SCT from a 23-weeks-gestation hydropic fetus, using gradually tightening umbilical tapes at the tumor base, electrocautery, and careful sharp dissection. After a blood transfusion, the fetus suffered cardiac arrest but was resuscitated and returned to the uterus.


RESULTS
Postoperatively, residual SCT growth ceased, and hydrops rapidly resolved. Five weeks after the procedure, the infant was delivered because of preterm labor, and, after resection of residual SCT, was discharged home at 3 months of age. She is now a healthy 3 year old.


CONCLUSIONS
This case shows that successful fetal SCT resection and long-term patient survival is possible.
Graf
J L
JL
Department of Surgery, Fetal Treatment Center, University of California, San Francisco 94143-0570, USA.
Albanese
C T
CT
Jennings
R W
RW
Farrell
J A
JA
Harrison
M R
MR
D004564:Electrocoagulation / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015160:Hydrops Fetalis / Q000150:complications / Q000601:surgery*; D011247:Pregnancy; D012445:Sacrococcygeal Region; D013724:Teratoma / Q000150:complications / Q000175:diagnosis / Q000601:surgery*