Sacrococcygeal teratoma with intraspinal extension: A case series and review of literature
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Feb 2020 · 1 min read
In brief
In brief
Case series of three infants with rare sacrococcygeal teratoma extending into the spinal canal, emphasizing the critical role of postnatal MRI for surgical planning. Authors advocate for multidisciplinary team approach involving neurosurgery and general surgery to achieve complete tumor resection while minimizing neurological complications.
Written by the GCMD Library team from the article.
Background
Sacrococcygeal teratoma (SCT) is the most common teratoma in neonates and arises from the coccyx. SCT with intraspinal invasion is extremely rare and only reported in a few cases.
Methods
37 patients with SCT were identified at our institution between 2000 and 2018. Three of these patients had SCT with intraspinal extension. A literature review for intraspinal extension associated with SCT, including mode of diagnosis, presentation, surgical approach and neurological sequelae, between 1993 and 2018 was also conducted.
Results
The authors report three cases of infants who were antenatally and/or postnatally diagnosed with a sacrococcygeal teratoma extending into the spinal canal. We illustrate the challenges of accurate diagnosis and therapeutic management. Postnatal magnet resonance imaging (MRI) was the best method to define spinal anatomy and extension of the tumors prior to surgery. Management with a multidisciplinary team approach including neuroradiology, neurosurgery and general surgery was used in our two most recent patients. The literature review yielded 6 cases of SCT with intraspinal extension.
Conclusion
Intraspinal extension in SCT is rare but should be excluded at birth before attempting any resection. In case of positive spinal invasion on Ultrasonography (US), MRI is essential to plan for surgery and possible laminectomy to be able to perform a radical resection of this congenital tumor. We recommend this multidisciplinary approach.
Level of evidence
Level IV.