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Ultrasound in Obstetrics & Gynecology :... Jun 2016The objectives of this study were to evaluate the efficacy of minimally invasive ablation of high-risk large sacrococcygeal teratomas (SCT) and to compare the efficacy... (Review)
Review
OBJECTIVES
The objectives of this study were to evaluate the efficacy of minimally invasive ablation of high-risk large sacrococcygeal teratomas (SCT) and to compare the efficacy of vascular and interstitial tumor ablation.
METHODS
This was a retrospective multicenter study including a cohort of fetuses with high-risk large SCTs between 2004 and 2010. In addition, we performed a systematic literature review of all cases that underwent tumor ablation in order to compare the survival rates after 'vascular' and 'interstitial' ablation. Statistical analysis was conducted using Bayesian methods.
RESULTS
In our cohort, a total of 13 fetuses had high-risk large SCT and five of them underwent tumor ablation. The estimated difference in hydrops resolution rate between the fetal intervention and the no fetal intervention groups was 44.6% (95% credibility interval, 1.5 to 81.0%; Pdiff> 0 = 97.9%). The estimated difference in survival rate between the fetal intervention and the no fetal intervention groups was 31.0% (13.9 to 48.1%; Pdiff> 0 = 99.9%). We analyzed our five cases together with 28 cases from the literature and estimated the difference in survival rate between the vascular and interstitial ablation groups as 19.8% (-13.1 to 50.1%; Pdiff> 0 = 88.3%). The estimated difference in hydrops resolution rate between the vascular and the interstitial ablation groups was 36.7% (-5.7 to 72.7%; Pdiff> 0 = 95.5%).
CONCLUSION
Minimally invasive surgery seems to improve perinatal outcome in cases of high-risk large fetal SCT. Our findings suggest that 'vascular' ablation may improve outcome and may be more effective than 'interstitial' tumor ablation, but this hypothesis needs further investigation in a larger multicenter prospective study. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Topics: Ablation Techniques; Cohort Studies; Female; Fetal Therapies; Humans; Minimally Invasive Surgical Procedures; Pregnancy; Retrospective Studies; Sacrococcygeal Region; Spinal Neoplasms; Survival Analysis; Teratoma; Treatment Outcome
PubMed: 26138446
DOI: 10.1002/uog.14935 -
BMJ Case Reports Feb 2023Teratomas in the neonatal age group are mostly benign at first, and the common site is the sacrococcygeal region. They are rarely associated with HIV infection. We...
Teratomas in the neonatal age group are mostly benign at first, and the common site is the sacrococcygeal region. They are rarely associated with HIV infection. We report a case of an HIV-exposed newborn with a congenital teratoma at the post-auricular site who developed an infection. Early intervention by total surgical resection will prevent complications such as infections and malignant transformation. A term baby was delivered spontaneously by an HIV-positive mother who was on her regular medications. Prenatal ultrasound carried out in the third trimester showed a cyst swelling on the right post-auricular region. Radiological imaging and the histopathological result revealed a congenital teratoma. A wide major excision with preservation of the facial nerve was performed at the age of 8 weeks. Post-auricular teratomas are the rarest anatomical location and the prevalence of malignant transformation from benign is very low. If left untreated, this tumour is associated with high mortality and malignant transformation rates. An early complete surgical excision allows a good result with a low risk of complications and recurrence.
Topics: Infant; Infant, Newborn; Pregnancy; Female; Humans; HIV Infections; Teratoma; Mothers; Sacrococcygeal Region; Cell Transformation, Neoplastic
PubMed: 36746517
DOI: 10.1136/bcr-2022-252977 -
Cureus Sep 2022Congenital thyroid teratomas are rare in the pediatric population as well as in the adult population. While they are typically found in the gonadal regions,...
Congenital thyroid teratomas are rare in the pediatric population as well as in the adult population. While they are typically found in the gonadal regions, extragonadally, they are commonly found in the sacrococcygeal region, with teratomas of the head and neck rarely found, comprising only about 1%-6% of all pediatric teratomas. Due to a concern for potential airway compromise and increased risk of malignancy with age, early surgical excision is recommended. In this case report, we present a two-year-old female who underwent laryngoscopy with subsequent right thyroid lobectomy for a large thyroid mass, which was found to be a congenital thyroid teratoma.
PubMed: 36304375
DOI: 10.7759/cureus.29395 -
The Journal of International Medical... May 2019We report here a rare case of adult sacrococcygeal teratoma (SCT) that was pathologically diagnosed as signet ring cell carcinoma (SRCC). A 26-year-old man complained of... (Review)
Review
We report here a rare case of adult sacrococcygeal teratoma (SCT) that was pathologically diagnosed as signet ring cell carcinoma (SRCC). A 26-year-old man complained of lower abdominal distension and discomfort and difficulty in urinating, and he was admitted to our hospital. Pelvic magnetic resonance imaging showed multiple oval, solid-cystic masses around the anterior sacrococcygeal region that measured approximately 96 × 114 × 89 mm. Magnetic resonance imaging also showed irregular cysts around the posterior sacrococcygeal region that measured approximately 34 × 72 × 60 mm. The preliminary diagnosis was cystic SCT. The patient then underwent surgery, during which we incised the cysts. A large amount of viscous, jelly-like liquid was present in the anterior sacrococcygeal mass. Furthermore, a large amount of light yellow, porridge-like secretion was present in the posterior sacrococcygeal mass. A pathological examination and immunohistochemistry confirmed teratoma, specifically SRCC.
Topics: Adult; Carcinoma, Signet Ring Cell; Humans; Magnetic Resonance Imaging; Male; Sacrococcygeal Region; Teratoma
PubMed: 30832522
DOI: 10.1177/0300060519831574 -
Case Reports in Pathology 2021Sacrococcygeal teratomas (SCT) are most commonly seen in infants and children but are rare in adults. Most adult SCT are benign and mature with a minority of tumors...
Sacrococcygeal teratomas (SCT) are most commonly seen in infants and children but are rare in adults. Most adult SCT are benign and mature with a minority of tumors having immature components or overt malignancy. Here, we report a 65-year-old female with a SCT developing adenocarcinoma. The patient was diagnosed with benign sacrococcygeal cystic teratoma on her initial hospital visit and was treated with surgical resection. She was followed up postoperatively and was noted to have a markedly elevated CA 19-9 level 13 months after the surgery. Radiological and clinical examination revealed thickening of the perirectal soft tissues, located near the inferior portion of her previous incision site. Histological evaluation of the lesion showed invasive, moderately differentiated adenocarcinoma. Immunohistochemical staining results were suggestive, but not diagnostic, of anal gland adenocarcinoma. This case report expands the knowledge regarding an adenocarcinoma arising from a previously benign, adult SCT.
PubMed: 34873455
DOI: 10.1155/2021/5045250 -
Cureus Dec 2023The present study aimed to review the treatment experience and outcomes of Currarino syndrome (CS) complicated with anorectal stenosis to evaluate the current treatment...
PURPOSE
The present study aimed to review the treatment experience and outcomes of Currarino syndrome (CS) complicated with anorectal stenosis to evaluate the current treatment strategies.
METHODS
Seven cases of CS complicated with anorectal stenosis, treated at our hospital between 1998 and 2021, were retrospectively investigated. This is a case series article from a single institution.
RESULTS
In six and three cases and one case, the presacral mass was a mature teratoma, meningocele, and lipoma, respectively. Resection of the lesion was performed in all six cases of mature teratoma, and duraplasty was performed before resection in all three cases of meningocele. Moreover, surgery for anorectal stenosis was performed simultaneously in four patients. Surgery was performed for six cases of anorectal stenosis, with the remaining case relieved by dilation using a metal bougie. The surgical methods used were a partial resection with end-to-end anastomosis, anorectal strictureplasty, pull-through, posterior sagittal anorectoplasty, and cutback after mass resection. Pathological analysis of the anorectal stenoses revealed disorganized and rough smooth muscle fibers and the replacement of the stroma by an increased quantity of collagen fibers.
CONCLUSIONS
The clinical outcomes of CS can be improved by establishing a treatment flow chart and understanding the complicated pathophysiology of the disease.
PubMed: 38226073
DOI: 10.7759/cureus.50512 -
CRSLS : MIS Case Reports From SLS 2022Extragonadal abdominopelvic teratomas in adults are extremely rare, and those in males are exceedingly rare. These masses are most commonly found incidentally and... (Review)
Review
BACKGROUND
Extragonadal abdominopelvic teratomas in adults are extremely rare, and those in males are exceedingly rare. These masses are most commonly found incidentally and require surgical excision for diagnostic confirmation after a thorough workup.
CASE PRESENTATION
This is a case report of a 49-year-old male who presented to a urology office with symptoms of hematuria, incidentally, found to have a pelvic mass on computed tomography urogram prompting colorectal surgical evaluation and subsequent laparoscopic complete excision. The clinical presentation, radiographic findings, and histopathological findings are described along with a literature review of extragonadal abdominopelvic mature cystic teratoma, also referred to as a sacrococcygeal teratoma.
DISCUSSION
A broad differential diagnosis was generated for this patient with a pelvic mass after complete work-up, consisting of a dermoid or epidermoid cyst, liposarcoma, or sacrococcygeal teratoma. Radiological features can aid in the diagnostic confusion that may present in the adult patient.
CONCLUSION
Albeit rare in the male and adult population, sacrococcygeal teratoma is a plausible differential diagnosis for a pelvic mass. Underrepresented in the literature in regard to guidelines on management, complete surgical excision is the gold standard, with laparoscopy being a reasonable approach.
Topics: Adult; Male; Humans; Middle Aged; Teratoma; Pelvic Neoplasms; Laparoscopy; Tomography, X-Ray Computed; Diagnosis, Differential
PubMed: 36299832
DOI: 10.4293/CRSLS.2022.00035 -
International Journal of Surgery Case... 2019Sacrococcygealteratoma is very rare in adults with only few cases reported in literature. It is a slow growing benign cystic tumor with 1-2% chance for malignant...
INTRODUCTION
Sacrococcygealteratoma is very rare in adults with only few cases reported in literature. It is a slow growing benign cystic tumor with 1-2% chance for malignant transformation and may attain a huge size causing pressure effect on pelvic and intra-abdominal organs. When grows caudally, it causes discomfort, skin excoriation and cosmetic disfigurement.
PRESENTATION OF CASE
We present a giant, long standing Sacrococcygeal teratoma in an adult female patient which caused her significant obstructing lower gastrointestinal and urinary symptoms besides the discomfort and disfigurement of the sacral region.
DISCUSSION
Sacrococcygeal teratomas are commonly present early in life but are very rare to be seen in adults with such a huge size in such a place where it interfered with patient sitting and sleeping. Diagnosis of our case was suspected by clinical examination, ultrasound and MRI while histopathology confirmed the diagnosis. It was completely excised along with the coccyx with primary wound closure and had a good postoperative recovery. Up till now, 18 months follow-up using clinical, biochemical and radiological assessment revealed no evidence of recurrence.
CONCLUSION
Sacococcygeal teratoma should be considered in the differential diagnosis of large pelvic masses in adults. In the presence of an extra-corporal and deep intra pelvic extension, we recommend the posterior perineal approach for excision as it has convenient control over the mass during surgery and good cosmetic results.
PubMed: 30522078
DOI: 10.1016/j.ijscr.2018.11.039 -
The Tokai Journal of Experimental and... Sep 2022A 6-month-old girl was presented to our hospital due to a presacral mass found 5 months after surgery of sacrococcygeal teratoma. The original tumor was a 63 x 50 mm...
A 6-month-old girl was presented to our hospital due to a presacral mass found 5 months after surgery of sacrococcygeal teratoma. The original tumor was a 63 x 50 mm sized round cyst connecting to the coccyx, observed with computed tomography. The initial operation was performed with removal of the tumor along with the coccyx in the prone position. During a routine follow up, ultrasonography indicated a possible local recurrence, 5 months after the initial operation. The magnetic resonance imaging revealed a polycystic formation with a diameter of 20 x 11 x 17 mm in the presacral space. The laparoscopic operation was conducted with the patient in the lithotomy and Trendelenburg position. The broad ligament of uterus was fixed to the abdominal skin and the rectum was mobilized to identify the tumor, which was resected laparoscopically. A histopathological examination showed the tumor to be a mature cystic teratoma. We observed her without any additional treatment and no recurrence is seen after 6 months.
Topics: Female; Humans; Infant; Laparoscopy; Sacrococcygeal Region; Spinal Neoplasms; Teratoma; Tomography, X-Ray Computed
PubMed: 36073281
DOI: No ID Found -
Journal of Clinical Medicine Apr 2024This study aims to evaluate the outcomes of fetal sacrococcygeal teratoma (SCT) submitted to prenatal interventions. We performed a systematic literature review of... (Review)
Review
This study aims to evaluate the outcomes of fetal sacrococcygeal teratoma (SCT) submitted to prenatal interventions. We performed a systematic literature review of fetal SCT patients and compared the outcomes between open fetal surgery and percutaneous intervention. In addition, we also compared the results of SCT fetuses who did not undergo any surgical intervention (NI). We identified 16 cases of open fetal surgery (OS), 48 cases of percutaneous fetal intervention (PI), and 93 NI patients. The survival rate was 56.2% in OS, 45.8% in PI ( = 0.568), and 71.0% in NI patients. The gestational age at delivery was earlier in cases where there was no survival compared to cases where the fetuses did survive across all evaluated cohorts (OS: = 0.033, PI: < 0.001, NI: < 0.001). The gestational weeks at delivery in OS and PI fetuses were more similar; however, OS tended to be performed later on in pregnancy, and the affected fetuses had more severe presented findings. In our evaluation, we determined that the presence of fetal hydrops and cardiac failure had no significant impact on survival in SCT cases. In NI patients, polyhydramnios was much higher in fetuses who did not survive compared to their surviving cohorts ( < 0.001). In conclusion, gestational age at delivery can affect the short-term prognosis of fetuses affected with sacrococcygeal teratomas. Regardless of the mode of delivery or the necessity for intervention during the fetal period, monitoring for complications, including polyhydramnios, can prevent premature delivery.
PubMed: 38731178
DOI: 10.3390/jcm13092649