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Sacrococcygeal Teratomas in Children and Adolescents - A Danish 26-Year Retrospective Cohort Study
Line Walther Lundbæk Siggaard1, Mark Bremholm Ellebæk2, Lene Gaarsmand Christensen3
1Department of Pediatric Hematology and Oncology, Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
Insights
Sacrococcygeal teratomas (SCTs) occur in 1 in 27,513 births. Long-term, 16% recur, 3% are fatal, and 25% of children face urological or anorectal issues.
Area of Science:
- Pediatric oncology
- Developmental biology
- Surgical oncology
Background:
- Sacrococcygeal teratomas (SCTs) are congenital tumors.
- Understanding their incidence and long-term outcomes is crucial for pediatric care.
Purpose of the Study:
- To determine the incidence of SCTs in children and adolescents in Denmark.
- To assess the outcomes and long-term sequelae associated with SCTs.
- To evaluate the risk factors for recurrence and mortality.
Main Methods:
- Nationwide retrospective register-based cohort study.
- Inclusion of all Danish children under 18 diagnosed with SCT from 1995-2021.
- Data combined from four national registries.
Main Results:
- Sixty-two patients identified; incidence of 1 in 27,513 live births.
- Tumor types: 48% mature, 34% immature, 18% malignant.
- Long-term sequelae: 24% urological, 22% anorectal; 16% recurrence rate; 3% SCT-related mortality.
Conclusions:
- SCT incidence remained stable.
- Significant rates of recurrence (16%) and long-term sequelae (25% urological/anorectal) observed.
- SCT-related mortality is 3%.
Objective:
To describe the incidence and assess the outcome and risk of long-term sequelae of sacrococcygeal teratomas (SCTs) in children and adolescents in Denmark.
Study Design:
A nationwide retrospective register-based cohort study of all Danish children aged under 18 years diagnosed with SCT (1995-2021), combining four national registries.
Results:
We identified sixty-two patients with a female to male ratio of 4.6:1. The median age at diagnosis was 18 days (range 0 days-17 years). The incidence of SCT was 1 out of 27,513 live births, with a prenatal detection rate of 44 %. The tumors consisted of mature tissue in 48 % of the cases, 34 % contained immature tissue, and 18 % had malignant tumors. Associated anomalies were present in 16 % of the cases. At the last follow-up (median 7.3 years), 24 % of the patients experienced urological sequelae, 22 % experienced anorectal sequelae, and 4 % experienced chronic pain. Ten recurrences occurred (16 %) during the study period, with a median time to recurrence of 1.76 years (range 0.27-6.56 years) from diagnosis. Five recurrences originated from mature teratomas, four from immature teratomas, and one from a malignant teratoma. The overall SCT-related mortality was 3 %. One mortality occurred in a premature child due to intraoperative complications and one occurred in a patient with a progressive malignant metastatic SCT.
Conclusion:
The incidence of SCTs remained stable throughout the study period. We found a recurrence rate of 16 % and an SCT related mortality of 3 %. At last follow-up, one in four children experienced urological and/or anorectal sequelae.
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