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Health and Quality of Life Outcomes Apr 2020The aims of this study were to evaluate health-related quality of life (HRQoL) in children with sacrococcygeal teratoma and to explore the effect of the scar on...
AIM
The aims of this study were to evaluate health-related quality of life (HRQoL) in children with sacrococcygeal teratoma and to explore the effect of the scar on physical, emotional and behavioral aspects.
METHODS
A cohort of children operated on for sacrococcygeal teratoma between 2000 and 2013 at Lund University Hospital, Sweden, and their parents were interviewed. HRQoL was evaluated with PedsQL, and scar satisfaction was estimated through Patient Observer Scar Assessment Score (POSA).
RESULTS
All eligible children (n = 17) were included (100% response rate). Median age was 7.3 years (range 3.5-16.0). Mean total PedsQL score was 92.3 (range 72.0 to 99.0). Patients with comorbidity scored lower (87.5) than those without (95.0) (p < 0.05). Pain during sitting down was reported by two (20%) patients, and itching was reported by another two patients (20%) aged > 8 years. No children reported that they avoided situations due to the scar, and most (80% of children and 90% of parents) reported absent or only mild negative emotions when considering the scar.
CONCLUSION
Children with sacrococcygeal teratoma had a good overall HRQoL, but comorbidity reduced the outcome. A few children reported scar-related impact on physical, behavioral and emotional aspects.
Topics: Adolescent; Child; Child, Preschool; Cicatrix; Cohort Studies; Female; Humans; Male; Patient Satisfaction; Quality of Life; Sacrococcygeal Region; Sweden; Teratoma
PubMed: 32303229
DOI: 10.1186/s12955-020-01350-y -
Cancer Management and Research 2020The present study aims to discuss the clinical features, treatment, and prognosis of fetal sacrococcygeal teratomas (SCTs) to improve the standard of diagnosis and...
OBJECTIVE
The present study aims to discuss the clinical features, treatment, and prognosis of fetal sacrococcygeal teratomas (SCTs) to improve the standard of diagnosis and treatment.
METHODS
The clinical data of 15 pregnant females with fetal SCT, admitted to Fujian Maternity and Child Health Hospital from January 2013 to January 2020, were retrospectively analyzed with respect to clinical characteristics, imaging features, complications, treatment options, and pregnancy outcomes.
RESULTS
The 15 cases of fetal SCT were all detected by color ultrasonography. There were two cases of cystic tumors and 13 cases of solid cystic tumors. In terms of tumor blood supply, there was one case without blood flow signal, eight cases with little blood flow signal, and six cases with abundant blood flow. At the time of delivery, there were two cases with a tumor diameter less than 5 cm, five cases with a diameter of 5-10 cm, and eight cases with a diameter of more than 10 cm. In terms of tumor shape and location, there were two cases of type I, ten cases of type II, and three cases of type III. There were six cases with an increased fetal heart to chest ratio, four cases of fetal edema, three cases of placental edema, four cases of excessive amniotic fluid, one case of insufficient amniotic fluid, three cases of fetal distress, one case of stillbirth, two cases of gestational diabetes mellitus, two cases of mirror syndrome, and two cases of postpartum hemorrhage. According to the pathological diagnosis, there were seven cases of mature teratoma, seven cases of immature teratoma, and one case of mixed germ cell tumor. There were six cases of induced delivery, nine cases of cesarean section, one case of premature birth, and two cases of mild neonatal asphyxia.
CONCLUSION
Fetal SCT was generally diagnosed by prenatal ultrasonography. The tumor blood supply, growth rate, size, nature of the tumor, clinical type, pathology, and maternal-fetal complications are all closely correlated with the prognosis. The timing and manner of the termination of pregnancy should be determined on the basis of the pregnant female, the fetus, and the tumor.
PubMed: 33380826
DOI: 10.2147/CMAR.S287682 -
African Journal of Paediatric Surgery :... 2022Parasitic conjoined twin is a rare but well-known entity with unclear embryopathogenesis. Abnormal conjoined twinning can result in an externally attached parasitic twin...
BACKGROUND
Parasitic conjoined twin is a rare but well-known entity with unclear embryopathogenesis. Abnormal conjoined twinning can result in an externally attached parasitic twin (PT), an enclosed foetus in foetu, or a mature teratoma. The treatment requires complete excision and reconstruction of local anatomy which is not always straightforward.
MATERIALS AND METHODS
PT cases presenting over 12 years were analysed. Patients with complete data, histopathological diagnosis and follow-up were included in the study. During follow-up, specific complications and related investigations were considered.
RESULTS
A total of five patients at four different sites were identified: two retroperitoneal foetus in foetu and three externally attached PTs which were located in the lumbar region, sacrococcygeal area and on the lower anterior abdominal wall. All patients underwent complete surgical excision. In foetus in foetu cases, the blood supply was directly from the aorta with a short stump while the three externally located ones required meticulous and careful dissection with the reconstruction of local anatomy.
CONCLUSION
Parasitic conjoined twinning can present at different sites and surgical challenges vary accordingly. For surface lesions, reconstruction may be as complicated as excision. Prognosis can be affected by the excellence of anatomical restoration. Long-term follow-up is essential to address problems specific to the site of lesion and method of surgical reconstruction.
Topics: Abdomen; Humans; Retroperitoneal Space; Teratoma; Twins, Conjoined
PubMed: 36018202
DOI: 10.4103/ajps.ajps_78_21 -
Cureus Mar 2023Sacrococcygeal masses encompass a diverse range of pathologies. Prenatal ultrasound facilitates early detection of congenital sacrococcygeal masses. We present the case...
Sacrococcygeal masses encompass a diverse range of pathologies. Prenatal ultrasound facilitates early detection of congenital sacrococcygeal masses. We present the case of a newborn of a 22-year-old woman who was identified to have a sacrococcygeal mass by prenatal ultrasound that was initially diagnosed as sacrococcygeal teratoma. On examination after delivery, a large midline mass in the sacrococcygeal region was observed, which was globular in shape and had smooth, thin skin with bluish discoloration. Magnetic resonance imaging revealed a cystic lesion that protruded through a caudal sacral defect, consistent with a sacrococcygeal meningocele. The patient underwent surgical repair of the meningocele without any intraoperative complications and had preserved motor function in the lower extremities after the procedure. This case underscores the challenge of distinguishing sacrococcygeal teratoma from meningocele based on clinical presentation and prenatal ultrasound findings. An accurate preoperative diagnosis is essential for effective surgical planning.
PubMed: 37090346
DOI: 10.7759/cureus.36485 -
Modern Pathology : An Official Journal... Feb 2021Mature ovarian teratoma is considered to be a parthenogenetic tumor that arises from a single oocyte/ovum. Conversely, complete hydatidiform mole (CHM) is androgenetic...
Mature ovarian teratoma is considered to be a parthenogenetic tumor that arises from a single oocyte/ovum. Conversely, complete hydatidiform mole (CHM) is androgenetic in origin: classic CHM arises from a single or two sperm. Since mature ovarian teratoma and CHM have only maternal and paternal genomes, respectively, their genome imprinting is theoretically reverse, but this has yet to be investigated. Genome imprinting in struma ovarii, a special form of mature teratoma, remains unclear. Although a mature teratoma can rarely arise in extragonadal sites, its genome imprinting, as well as cell origin, is poorly understood. One of the most important mechanisms of genome imprinting is DNA methylation. To investigate the methylation profile of imprinted genes, we performed methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) of 21 imprinting control region (ICRs) of 9 imprinted genes/gene clusters in formalin-fixed, paraffin-embedded samples obtained from 12 mature ovarian teratomas, 6 struma ovarii, 10 CHMs, and 7 extragonadal (1 sacrococcygeal, 6 mediastinal) mature teratomas of females. In mature ovarian teratomas, ICRs of maternally and paternally imprinted genes showed high and low levels of methylation, respectively, and this pattern was almost reverse in CHMs. In CHMs, however, some ICRs showed aberrant methylation. The methylation profile of struma ovarii was comparable to that of mature ovarian teratomas, except for an adenomatous tumor. In extragonadal mature teratomas, the methylation pattern was somatic or irregular. In conclusion, mature ovarian teratomas/struma ovarii, CHMs, and extragonadal mature teratomas showed distinct methylation profiles of imprinted genes. Ovarian teratomas and CHMs are most likely to inherit their methylation profiles from their ancestral germ cells, although some aberrant methylation suggests a relaxation of imprinting in CHMs and a subset of struma ovarii. Extragonadal mature teratomas may carry a methylation profile of misplaced primordial germ cells or possibly somatic cells that have been reprogrammed in vivo.
Topics: DNA Methylation; Female; Genomic Imprinting; Humans; Hydatidiform Mole; Ovarian Neoplasms; Pregnancy; Teratoma; Uterine Neoplasms
PubMed: 32873866
DOI: 10.1038/s41379-020-00668-8 -
African Journal of Paediatric Surgery :... 2022Teratomas are true neoplasms derived from the three germ layers. They are relatively rare tumours. They present in the sacrococcygeal region, gonads and retroperitoneum... (Review)
Review
Teratomas are true neoplasms derived from the three germ layers. They are relatively rare tumours. They present in the sacrococcygeal region, gonads and retroperitoneum commonly. We present the report of a 5-month-old infant who presented with a prolapsing oropharyngeal teratoma and literature review.
Topics: Abdomen; Humans; Infant; Sacrococcygeal Region; Teratoma
PubMed: 35775522
DOI: 10.4103/ajps.AJPS_68_20 -
Journal of Medical Case Reports Jun 2020Sacrococcygeal teratoma is one of the most frequently prenatally diagnosed neoplasias. Obstetric ultrasound has a role in the diagnosis and management of these tumors...
BACKGROUND
Sacrococcygeal teratoma is one of the most frequently prenatally diagnosed neoplasias. Obstetric ultrasound has a role in the diagnosis and management of these tumors during pregnancy. In this report, we describe a multidisciplinary approach in a case of a patient with sacrococcygeal teratomas and preterm delivery, as well as postnatal outcomes.
CASE PRESENTATION
A 26-year-old Caucasian woman at 20.3 weeks of gestation with a normal gestational course and no relevant medical or surgical history was referred to our institution with a sacrococcygeal mass diagnosis. Magnetic resonance imaging confirmed the diagnosis of sacrococcygeal teratoma type I according to the Altman classification. Follow-up with ultrasound showed an increase in the size of the mass up to 190 × 150 mm, high Doppler flow, and severe polyhydramnios. At 35.1 weeks of gestation, the patient had premature rupture of membranes, and an emergency cesarean section was performed due to recurrent late decelerations detected by fetal heart rate monitoring. Afterward, surgery was performed successfully at 36 hours of life. Posterior controls revealed normal and healthy child growth.
CONCLUSIONS
This case report demonstrates the importance of a multidisciplinary approach to offer the best neonatal outcomes by performing early surgery, as well as the need for follow-up by ultrasound in order to minimize complications by assessing mass growth, Doppler flow, and amniotic fluid.
Topics: Adult; Cesarean Section; Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Magnetic Resonance Imaging; Male; Patient Care Team; Pregnancy; Premature Birth; Prenatal Diagnosis; Sacrococcygeal Region; Teratoma; Ultrasonography, Prenatal
PubMed: 32552844
DOI: 10.1186/s13256-020-02395-9 -
JNMA; Journal of the Nepal Medical... Aug 2023Sacrococcygeal teratomas are common tumours in neonates and infants, primarily affecting females. A 35-year-old primigravida presented with a large sacrococcygeal...
UNLABELLED
Sacrococcygeal teratomas are common tumours in neonates and infants, primarily affecting females. A 35-year-old primigravida presented with a large sacrococcygeal teratoma that was detected during the 30th week of gestation in the fetus. The baby was delivered via elective caesarean section at 36+3 weeks, and surgical excision of the 10x10x5 cm³ mass was performed successfully on the third day of life. Despite a surgical site infection, the patient had a favourable outcome with normal vital signs, bowel, bladder, and lower extremity functions upon discharge. Early diagnosis and prompt management of sacrococcygeal teratoma in newborns is vital for optimal outcomes, providing valuable insights and guidance to medical practitioners.
KEYWORDS
anaesthesia; case reports; neonate; teratoma.
Topics: Humans; Pregnancy; Infant, Newborn; Female; Adult; Cesarean Section; Sacrococcygeal Region; Teratoma; Spinal Neoplasms; Anesthesia
PubMed: 38289807
DOI: 10.31729/jnma.8251 -
Cirugia Pediatrica : Organo Oficial de... Apr 2020Sacrococcygeal teratoma (SCT) is the most frequent congenital germ cell tumor. Patients have a higher risk of perinatal complications and death, with bleeding and... (Review)
Review
Sacrococcygeal teratoma (SCT) is the most frequent congenital germ cell tumor. Patients have a higher risk of perinatal complications and death, with bleeding and cardiac decompensation being the most common causes of neonatal mortality. This is the case of a 35-week preterm newborn with a large SCT diagnosed at ultrasound screening in the second trimester. Preoperative selective embolization of the middle sacral artery and total surgical resection were performed postnatally with minimal blood loss. The patient was discharged at 25 days of life with a normal physical examination. Selective embolization prior to giant SCT resection is feasible and appears as a safe and useful technique in the control of perioperative bleeding.
Topics: Embolization, Therapeutic; Humans; Infant, Newborn; Infant, Premature; Preoperative Care; Sacrococcygeal Region; Teratoma; Tumor Burden
PubMed: 32250074
DOI: No ID Found -
BMC Endocrine Disorders Jul 2021Vaginal paraganglioma are rare, atypical, solitary tumors which originate from the female genital tract. Sacrococcygeal teratoma are also rare neoplasms which derive...
BACKGROUND
Vaginal paraganglioma are rare, atypical, solitary tumors which originate from the female genital tract. Sacrococcygeal teratoma are also rare neoplasms which derive from one (or more) primordial germ cell layers. Here we report a unique case of vaginal paraganglioma with sacrococcygeal teratoma.
CASE PRESENTATION
A 44-year-old female experienced paroxysmal hypertension, palpitations and dizziness for almost six years. Enhanced CT and MRI highlighted two abnormal soft tissue lesions located in the left vaginal wall and coccyx anteriorly, and Iodine-131 metaiodobenzylguanidine (I-MIBG) demonstrated abnormal radioactive uptake in perineum area. Endocrine tests showed elevated plasma normetanephrine (NMN) and 24 h urine norepinephrine. There was a well-circumscribed soft tissue lesion of approximately 3.5 cm in the left lateral vaginal wall which could be palpated during bimanual examination, together with a 1.5 cm tumor in the posterior wall of the rectum. We completely resected the two lesions in stages with the support of a senior gynecologist and general surgeons. Postoperative histopathological examinations suggested the vaginal paraganglioma and mature sacrococcygeal teratoma. Targeted sanger sequencing for the 36 mostly common paraganglioma-related genes, with a depth of 1000x, revealed no mutations. Post-operatively, plasma NMN and 24 h urine norepinephrine returned to the normal range and her symptoms completely disappeared.
CONCLUSIONS
We reported an extremely rare case and the successful treatment of functional vaginal paraganglioma coexisting with adult sacrococcygeal teratoma.
Topics: Adult; Female; Humans; Magnetic Resonance Imaging; Norepinephrine; Normetanephrine; Paraganglioma; Sacrococcygeal Region; Teratoma; Tomography, X-Ray Computed; Vaginal Neoplasms
PubMed: 34233670
DOI: 10.1186/s12902-021-00806-6