Similar articles

Abstract: Objective: To determine the clinical, imaging, and histological features, and surgical resection modalities and outcomes of adult sacrococcygeal teratoma (SCT). Methods: Adult patients with histopathologically diagnosed SCT were enrolled in our hospital between August 2010 and August 2018. Each patient’s characteristics and clinical information were reviewed. Results: There were 8 patients in the study (2 males, 6 females) with a median age of 34 years (range, 18–67 years). The time to clinical symptoms was 14 d to 35 years, with a median time of 4 years. Six patients presented with symptoms of sacrococcygeal pain, and four with signs of sacrococcygeal mass and ulceration in the sacrococcygeal region. Six patients were evaluated using a combination of computed tomography (CT) and magnetic resonance imaging (MRI). All patients showed a presacral tumor with heterogeneous intensity on CT images. All patients underwent surgical treatment, including 6 parasacral, 1 transabdominal, and 1 combined anterior-posterior surgery cases. Seven patients were histopathologically diagnosed with benign mature SCT, and have shown no recurrence. One patient had malignant SCT, with recurrence at 84 months after surgery. After a second surgery, the patient had no recurrence within 6 months follow-up after re-resection. Conclusions: Our retrospective study demonstrated: (1) adult SCT is difficult to diagnose because of a lack of typical clinical symptoms and signs; (2) a combination of CT and MRI examination is beneficial for preoperative diagnosis; (3) the choice of surgical approach and surgical resection modality depends on the size, location, and components of the tumor, which can be defined from preoperative CT and MRI evaluation; (4) most adult SCTs are benign; the surgical outcome for the malignant SCT patient was good after complete resection. Even for the patient with recurrent malignant SCT, the surgical outcome was good after re-resection.

成年骶尾部畸胎瘤的诊治:单中心8年经验回顾

[1]Emoto S, Kaneko M, Murono K, et al., 2018. Surgical management for a huge presacral teratoma and a meningocele in an adult with Currarino triad: a case report. Surg Case Rep, 4(1):9.

[2]Firszt OP, Myga-Porosiło J, Pośpieszny K, et al., 2018. Radiological features of sacrococcygeal teratomas in fetal magnetic resonance imaging and computed tomography—a case report. Pol J Radiol, 83:e19-e23.

[3]Hambraeus M, Al-Mashhadi A, Wester T, et al., 2018a. Functional outcome and health-related quality of life in patients with sacrococcygeal teratoma—a Swedish multicenter study. J Pediatr Surg, in press.

[4]Hambraeus M, Hagander L, Stenstrom P, et al., 2018b. Long-term outcome of sacrococcygeal teratoma: a controlled cohort study of urinary tract and bowel dysfunction and predictors of poor outcome. J Pediatr, 198: 131-136.e2.

[5]Hiller DJ, Waters GS, Bohl JL, 2015. Incidence and operative excision of presacral masses: an institutional analysis. Am Surg, 81(12):1237-1239.

[6]Hunter CJ, Ford HR, Estrada JJ, et al., 2009. Alpha-fetoprotein levels correlate with the pathologic grade and surgical outcomes of pediatric retroperitoneal teratomas. Pediatr Surg Int, 25(4):331-336.

[7]Kremer MEB, Dirix M, Koeneman MM, et al., 2015. Quality of life in adulthood after resection of a sacrococcygeal teratoma in childhood: a Dutch multicentre study. Arch Dis Child Fetal Neonatal Ed, 100(3):F229-F232.

[8]Luk SY, Tsang YP, Chan TS, et al., 2011. Sacrococcygeal teratoma in adults: case report and literature review. Hong Kong Med J, 17(5):417-420.

[9]Mengual-Ballester M, Pellicer-Franco E, Valero-Navarro G, et al., 2014. Presacral tumor as a differential diagnosis of recurrent pilonidal sinus. Cir Cir, 82(5):567-572.

[10]Patel N, Maturen KE, Kaza RK, et al., 2016. Imaging of presacral masses—a multidisciplinary approach. Br J Radiol, 89(1061):20150698.

[11]Saba L, Fellini F, Greco FG, et al., 2014. MRI evaluation of not complicated Tailgut cyst: case report. Int J Surg Case Rep, 5(10):761-764.

[12]Saxena D, Pandey A, Bugalia RP, et al., 2015. Management of presacral tumors: our experience with posterior approach. Int J Surg Case Rep, 12:37-40.

[13]Shatnawi NJ, Khammash MR, Omari AH, 2019. A giant sacrococcygeal teratoma in adult female: a case report. Int J Surg Case Rep, 54:47-50.

[14]Sheng QS, Xu XM, Cheng XB, et al., 2015. Multi-stage resection and repair for the treatment of adult giant sacrococcygeal teratoma: a case report and literature review. Oncol Lett, 10(1):425-429.

[15]Simpson PJ, Wise KB, Merchea A, et al., 2014. Surgical outcomes in adults with benign and malignant sacrococcygeal teratoma: a single-institution experience of 26 cases. Dis Colon Rectum, 57(7):851-857.

[16]Sukhadiya MV, Das U, 2015. Laparoscopic approach to type IV sacrococcygeal teratoma in an adult. Indian J Surg, 77(Suppl 1):62-63.

[17]Szyllo K, Lesnik N, 2013. Sacrococcygeal teratoma—case report and review of the literature. Am J Case Rep, 14:1-5.

[18]https://doi.org/10.12659/AJCR.883727

[19]Varma AV, Malpani G, Agrawal P, et al., 2017. Clinicopathological spectrum of teratomas: an 8-year retrospective study from a tertiary care institute. Indian J Cancer, 54(3):576-579.

[20]Wessell A, Hersh DS, Ho CY, et al., 2018. Surgical treatment of a type IV cystic sacrococcygeal teratoma with intraspinal extension utilizing a posterior-anterior-posterior approach: a case report. Childs Nerv Syst, 34(5):977-982.