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Sacrococcygeal teratoma.

Ashish Wakhlu1, Sanjeev Misra, R K Tandon

  • 1Department of Pediatric Surgery, King George's Medical College, Lucknow, UP, India. ashish_wakhlu@hotmail.com

Pediatric Surgery International
|November 5, 2002
PubMed
Summary

Sacrococcygeal teratoma treatment in 72 patients over 17 years shows surgical approaches and chemotherapy impact. Early diagnosis via rectal exam and cisplatinum-based chemotherapy improved outcomes for malignant tumors.

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Area of Science:

  • Pediatric Surgery
  • Surgical Oncology
  • Developmental Biology

Background:

  • Sacrococcygeal teratomas (SCTs) are congenital tumors with varied presentations and outcomes.
  • Delayed diagnosis, particularly for intrapelvic lesions, can lead to complications like bowel/urinary obstruction.

Purpose of the Study:

  • To analyze the treatment outcomes of 72 patients with SCTs over a 17-year period.
  • To evaluate the effectiveness of different surgical techniques and adjuvant therapies, including chemotherapy, for benign and malignant SCTs.

Main Methods:

  • Retrospective review of 72 patients treated for SCTs.
  • Surgical interventions included sacral excision, abdominosacral excision, and preliminary colostomy.
  • Post-operative monitoring included serum alpha-fetoprotein (AFP) and imaging; cisplatinum-based chemotherapy was used for malignant cases.

Main Results:

  • 47 benign SCTs: 42 excised via sacral route with no recurrence in survivors. 4 deaths occurred.
  • 25 malignant SCTs: cisplatinum-based chemotherapy improved survival, with 10 of 11 patients alive at 1 year post-surgery.
  • No functional neurological deficits reported; rectal examination recommended for early diagnosis.

Conclusions:

  • Sacral excision is effective for benign SCTs, with no recurrence observed.
  • Preliminary colostomy and abdominosacral excision are beneficial for large lesions, reducing morbidity.
  • Cisplatinum-based chemotherapy significantly enhances survival rates for patients with malignant sacrococcygeal teratomas.

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