Perinatal outcome of sacrococcygeal teratoma.
OBJECTIVE
To evaluate the outcome in a cohort of fetuses with isolated sacrococcygeal teratoma (SCT) in relation to the need for in utero intervention.


METHODS
We retrospectively analyzed a cohort of fetuses prenatally diagnosed with SCT between September 2000 and December 2010. Postnatal outcomes were evaluated in relation to the need for intervention in utero by reviewing medical records.


RESULTS
Of the 35 fetuses diagnosed with SCT during the study period, ten were lost to follow up and three had been misdiagnosed as SCT. Among the remaining 22 cases, in utero interventions were performed in eight, including radiofrequency ablation (RFA) in four, shunt operations in two, RFA plus cyst aspiration in one, and RFA with subsequent shunt operation in one. Tumors of cases undergoing in utero intervention were larger with rapidly growing, more frequently vascular, and with associated polyhydramnios or cardiomegaly. The rate of preterm births was higher in the cases that underwent interventions compared with those that did not (7/8 vs 2/14). Only one tumor showed regression after RFA while the other seven increased in size. Median tumor size at birth was significantly larger in the intervention group than in the nonintervention group (136 mm vs 80 mm). The neonatal survival rate was 6/8 for the prenatal intervention group and 14/14 for the nonintervention group. Resection of SCT was required in all neonates. The most common complication after postnatal surgery was fecal incontinence.


CONCLUSIONS
Fetuses with SCT undergoing in utero intervention have worse prognostic features, yet their neonatal outcome is similar to those of fetuses not requiring intervention.
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Mi-Young
MY
Lee
Hye-Sung
HS
Won
Min-Kyung
MK
Hyun
Hee-Young
HY
Lee
Jae-Yoon
JY
Shim
Pil-Ryang
PR
Lee
Ahm
A
Kim
D000008:Abdominal Neoplasms / Q000151:congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation; D015331:Cohort Studies; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D046128:Fetal Therapies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology; D012189:Retrospective Studies; D012445:Sacrococcygeal Region; D013724:Teratoma / Q000151:congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal