Urogenital anomalies in girls with sacrococcygeal teratoma: a commonly missed association.
BACKGROUND
The association of urogenital (UG) anomalies and sacrococcygeal teratoma (SCT) has not been widely reported. Our aim was to look at the national incidence and presentation of this anomaly in patients with SCT and to provide the first report of a clear anatomical description of this commonly missed association.


METHODS
Sacrococcygeal teratoma cases in Scotland during the last 30 years were identified. Patients with associated UG anomalies were reviewed in detail to identify their presentation, anatomy, and management.


RESULTS
Fifty-three patients with SCT were identified, including 41 girls. Five girls (12%) subsequently had a UG anomaly diagnosed, which was not apparent at the initial surgery. Two patients presented with retention, and their anomaly was diagnosed at 6 weeks and 7 months of age. The other 3 presented with incontinence, and despite thorough assessment, including cystoscopy, their UG anomalies were not recognized until the ages of 7, 9, and 13 years.


CONCLUSIONS
Urogenital anomalies are surprisingly common in girls with SCT. The reason for this association is unclear. None of these cases were diagnosed initially, which means that it was either missed or acquired. Urogenital anomalies should be suspected in girls with SCT and actively excluded in those with voiding difficulties.
Department of Paediatric Surgery, Royal Hospital for Sick Children, Glasgow, UK. mshalaby@doctors.org.uk
Mohamed Sameh
MS
Shalaby
Stuart
S
O'Toole
Chris
C
Driver
Tim
T
Bradnock
Jimmy
J
Lam
Robert
R
Carachi
D000293:Adolescent; D002648:Child; D015897:Comorbidity; D003558:Cystoscopy; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D015160:Hydrops Fetalis / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012445:Sacrococcygeal Region; D012606:Scotland / Q000453:epidemiology; D013724:Teratoma / Q000453:epidemiology* / Q000601:surgery; D014521:Urethra / Q000002:abnormalities; D014522:Urethral Diseases / Q000453:epidemiology; D001743:Urinary Bladder / Q000002:abnormalities / Q000601:surgery; D014547:Urinary Diversion; D014548:Urinary Fistula / Q000453:epidemiology; D014555:Urination Disorders / Q000209:etiology; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000453:epidemiology*; D014624:Vaginal Fistula / Q000453:epidemiology