What Is Sacrococcygeal Teratoma?
Sacrococcygeal Teratoma is one of the most common germ cell tumors found in newborns. It is estimated that 1 out of every 40,000 live births has a Sacrococcygeal Teratoma. This is a tumor that develops before the child is born and grows from the tailbone of the fetus. The tumor in most cases is covered with skin but sometimes it is also covered with membranes.
In majority of the cases, there are many blood vessels that come through the Sacrococcygeal Teratoma. The size of the tumor is variable and ranges from very small to abnormally large. Sometimes, these tumors tend to grow outwards from the tailbone towards the stomach of the fetus. Sacrococcygeal Teratomas are basically classified into four categories. These categories are:
- Type I Sacrococcygeal Teratoma: These tumors are external and originate at the tailbone of the child
- Type II Sacrococcygeal Teratoma: These tumors grow both externally as well as internally
- Type III Sacrococcygeal Teratoma: These types of tumors are visible externally but are basically inside the body in the abdomen of the fetus
- Type IV Sacrococcygeal Teratoma: These tumors are far more serious types of tumors and are not visible. They are present inside the body and originate at the tailbone
What Causes Sacrococcygeal Teratoma?
The root cause of a Sacrococcygeal Teratoma is not known but it is believed to be a type of a germ cell tumor. Germ cell tumors are tumors which develop in the embryo and grow with the fetus to become a part of the reproductive system of the infant. Majority of germ cell tumors occur in the testes or the ovaries. In some cases, these tumors grow outside the gonads and continue to grow and multiply eventually forming a teratoma.
What Are The Symptoms Of Sacrococcygeal Teratoma?
The presenting features of Sacrococcygeal Teratomas depend on the size and location of the tumor. Small tumors are generally asymptomatic and can be removed after delivery of the child with surgery without any specific complications. Large tumors however can cause a variety of symptoms as they grow rapidly and thus require large amount of blood flowing through them. This result in fetal heart failure which is a condition called hydrops. There may be pleural effusion and pericardial effusion seen in the fetus associated with hydrops.
How Is Sacrococcygeal Teratoma Diagnosed?
A prenatal ultrasound may be good enough to identify the presence of a Sacrococcygeal Teratoma in the fetus. The mother of the unborn child with Sacrococcygeal Teratoma will have an abnormally shaped uterus as a result of a large sized tumor.
Some of the rare presentations which may be suspicious of a Sacrococcygeal Teratoma are maternal preeclampsia. This suspicion may lead to a prenatal ultrasound which will confirm the diagnosis of Sacrococcygeal Teratoma.
How Is Sacrococcygeal Teratoma Treated?
Surgery is the frontline treatment for Sacrococcygeal Teratoma. The surgery is normally done after the child is born. However, in cases of hydrops where the life of the fetus is at stake, then a fetal surgery may be performed to remove the Sacrococcygeal Teratoma and restore normal blood flow and prevent heart failure in the fetus. Other than that, once a child is born depending on the location and size of the tumor, a surgical procedure will be required to remove the tumor and treat Sacrococcygeal Teratoma.