Preoperative embolization of giant sacrococcygeal teratoma in a premature newborn.
Resection of a large vascular sacrococcygeal teratoma (SCT) in a newborn has the potential to be a fatal procedure caused by hemolysis, rupture, or bleeding of the tumor. Usually, most blood supply of an SCT is derived from the middle sacral artery. As soon as these arteries have been ligated, further blood loss is minimal. There is only one previous presentation about preoperative embolization of these arteries. We present a case in which the feeding arteries of a giant SCT were embolized in an infant born at 30 weeks and 3 days of gestation. Although bleeding during the surgery was minimal, continuous need of transfusions and life-threatening hyperkalemia created severe problems during surgery, until tumor resection was completed. This is the smallest reported patient in whom SCT was preoperatively treated by embolization.
Department of Pediatric Surgery, Tampere University Hospital, Pediatric Research Centre, University of Tampere, 33521 Tampere, Finland. tuija.lahdes-vasama@pshp.fi
Tuija Terhikki
TT
Lahdes-Vasama
Päivi H
PH
Korhonen
Janne M
JM
Seppänen
Outi K
OK
Tammela
Tarja
T
Iber
D016063:Blood Loss, Surgical / Q000517:prevention & control; D017115:Catheter Ablation; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D006947:Hyperkalemia / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007431:Intraoperative Complications / Q000453:epidemiology; D011300:Preoperative Care / Q000379:methods*; D012445:Sacrococcygeal Region / Q000098:blood supply / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000098:blood supply / Q000601:surgery* / Q000628:therapy*; D013724:Teratoma / Q000098:blood supply / Q000601:surgery* / Q000628:therapy*; D016216:Ultrasonography, Prenatal