Long term functional outcome of sacrococcygeal teratoma in a UK regional centre (1993–2006)
ABSTRACT Sacrococcygeal teratoma (SCT) is the commonest neonatal neoplasm. Its long-term effects are important in prenatal counseling and the delivery of an appropriate postoperative plan.
To determine the long-term functional outcome after SCT excision in a UK regional center.
Follow-up data for all patients with a SCT excised at the John Radcliffe Hospital in Oxford was collected retrospectively from notes and prospectively in clinic visits.
Clinical evidence of bowel or bladder impairment, mortality.
Over a 14-year period, 18 patients had a histologic diagnosis of SCT. Nine patients (50%) were born, 7 (39%) were terminated, and 2 (11%) were stillbirths. Of the 9 patients who had SCT resection, 4 (44%) were antenatally diagnosed. There were no perioperative deaths and alpha-fetoprotein levels normalized by 6 to 12 months after tumor resection. Median follow-up of patients was 30 months (range: 6 to 132 mo) with 1 patient lost to follow-up at 6 months, although he was asymptomatic at the time. Three patients developed urologic complications (2 within 1 year of tumor resection), including 2 patients with neurogenic bladder dysfunction and 1 patient with detrusor sphincter dyssynergia.
Approximately one-third of patients will develop major urologic complications after resection of SCT. Routine ultrasonography in the first postoperative year after tumor resection may help to identify patients with neuropathic bladder at the early stage and predict late complications. Parents need to be aware of this potential long-term complication during prenatal counseling and the need for regular long-term follow-up with the pediatric surgical team.
Article: Neonatal teratomas[Show abstract] [Hide abstract]
ABSTRACT: Teratomas are composed of multiple tissues foreign to the organ or site in which they arise. Their origin is postulated by 3 theories one of which is the origin from totipotent primodial germ cells. Anatomically, teratomas are divided into gonadal or extragonadal lesions and histologically they are classified as mature or immature tumors. Teratomas are mainy isolated lesions and may occur anywhere in the body. In the neonatal age group most of these tumors are benign and occur mainly in the sacrococcygeal area followed by the anterior mediastinum. Diagnosis is usually established prenatally and may require intervention in compromised fetuses. Postnatal imaging with ultrasound, CT scan or MRI provides useful information for surgical intervention. Complete surgical excision is the treatment of choice for neonatal teratomas. Alpha feto protein is the tumor marker of choice and is particularly useful for assessing the presence of residual or recurrent disease.Early human development 09/2010; 86(10):643-7. DOI:10.1016/j.earlhumdev.2010.08.016 · 1.93 Impact Factor
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