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Delayed En Bloc Excision of L3 for Metastatic Sacrococcygeal Teratoma on a 1-Year-Old Boy: A Case Report
Sandra Tötterman1,2, Johanna Syvänen1, Marika Grönroos3
1Department of Pediatric Surgery and Orthopedics, University of Turku, Turku University Hospital, Turku, Finland.
Case:
A 1-year old boy was presented with cauda equina syndrome and progressive loss of motor function in lower limbs. MRI and CT scans revealed a sacrococcygeal teratoma with metastases para-aortically and in L3 producing compression into the epidural space. Despite metastases and a progressive cauda equina, neoadjuvant treatment was given to achieve cytoreduction for neurological recovery and facilitate curative treatment.
Conclusion:
Malignant sacrococcygeal teratoma with intraspinal infiltration or metastasis requires surgical and adjuvant treatment. If primary neurologic function-sparing surgery makes curative treatment impossible, adequate and quick decompression of neural structures with similar results can be achieved by preoperative chemotherapy, avoiding the local spill of malignant cells.
