2009-08-09-03 Sacrococcygeal teratoma, type I © Volkov www.thefetus.net/
Sacrococcygeal teratoma, type I
Andrey Volkov, MD, PhD*; V. Voloshin, MD, PhD**; E. Filippskiy, MD***.
* Department of Obstetric and Gynecology ¹ 1, Rostov Medical University, Rostov on Don, Russia;
** Pathological Anatomy Department, Rostov Medical University, Rostov on Don, Russia;
*** Pathological Anatomy Department of Municipal Hospital ¹ 20, Rostov on Don, Russia.
A 36-year-old woman (G6Р2A3) was referred to our antenatal unit at 29 weeks of her pregnancy, with a non-contributive family history and negative anamnesis of exposure to teratogenic agents. The ultrasound revealed a diamniotic dichorionic twin pregnancy. A tumor in sacrococcygeal region was found in one of the fetuses. The color Doppler detected an arterio-venous blood flow within the tumor (Image 4). Polyhydramnios was present in the amnion of the affected fetus. The findings were suggestive of sacrococcygeal teratoma (type I - predominantly external form).
The second fetus showed no structural abnormalities but the absence of diastolic flow was detected at the level of the umbilical artery (Image 5).
Both fetuses were in breech presentation. Pregnancy was terminated at 29 weeks and 5 days via cesarean section. Two female newborns were delivered (1400 g - normal, and 2500 g - affected neonate, with Apgar scores of 6/7 and 4/5 respectively). The child with sacrococcygeal teratoma died 22 hours after delivery.
Images 1, 2, 3, and 4: 29 weeks, twin pregnancy; the images show several grayscale and color Doppler (Image 4) scans through the sacrococcygeal teratoma of the affected fetus.
Image 5: 29 weeks, twin pregnancy; the image shows absence of diastolic blood flow at the level of the umbilical artery of the unaffected fetus.
Images 6, 7, 8: The images represent pathological specimen of the affected neonate. Large sacrococcygeal teratoma can be seen. The image 8 represents a cross section of the tumor.
Images 9: X-ray image of the affected newborn with the sacrococcygeal teratoma.
Images 10 - 20: Histological images showing immature sacrococcygeal teratoma.