2000-04-25-12 Sacrococcygeal teratoma, Type I © Clavelli www.thefetus.net/
Sacrococcygeal teratoma, Type I
Adrian Werther Clavelli,* MD and Fernando L. Heinen#, MD
*Diagnostico Maipu, Buenos Aires, Argentina
#Pediatric Surgeon, Av. Crámer 1853 8C, (1428) Buenos Aires, Argentina
This is a fetus that was referred with a suspicion of meningomyelocele. Actually, note the normal skull, and spine, this fetus was recognized to have a Type I (external) sacorcoccygeal teratoma. The lesion is predominantly cystic.
No cardiac failure (see below the Doppler image with no flow through the lesion)
Doppler did not find abnormally increased flow.
Normal spine (no spinal defect)
The saccrococcygeal teratoma.
Surgery was performed 24 hours after a smooth C-section delivery. The birth weight was 3630 grams, Apgar 10/10. The tumor was 90% cystic (250 cc) and a solid component was attached to the precoccigeal area (nut size). Excision was 100% complete with the coccis. The tumor base was asymmetric to the left of the midline raphe. Levator ani and sphincters were realigned and repaired adequately . The cosmetic result is acceptable after skin flaps were raised to corrected the dysplaced intergluteal line.
The baby has successfully initiated breast feeding without complications, at her first postop day in normal conditions.
Ventral and dorsal appearance of the large cystic component.
Inferior aspect of the lesion and the anus.
After surgical preparation, the cyst is opened and dissected out
Dissection of the solid component
After resection and realignment of the gluteal fold and anus