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Urological aspects of sacrococcygeal teratoma in children
Y Reinberg1, R Long, J C Manivel
1Department of Urologic Surgery, University of Minnesota, Minneapolis.
Insights
Sacrococcygeal teratomas in infants rarely cause urological issues, with type IV (presacral) tumors posing the highest risk. Early evaluation is recommended for all infants with these tumors.
Area of Science:
- Pediatric Surgery
- Urology
- Oncology
Background:
- Sacrococcygeal teratoma is the most common infantile extragonadal germ cell tumor.
- Urological complications are known but often associated with malignancy.
Purpose of the Study:
- To assess the impact of sacrococcygeal teratoma grade and type on urological outcomes.
- To identify specific tumor characteristics associated with adverse urological events.
Main Methods:
- Retrospective chart review of 29 pediatric patients with sacrococcygeal teratoma.
- Correlation analysis between tumor grade/type and documented urological complications.
Main Results:
- No correlation found between tumor grade and urological complications.
- Neurogenic bladder (12%), ureteral obstruction (10%), and vesicoureteral reflux (7%) were the most common complications.
- Type IV (presacral) sacrococcygeal teratomas showed the highest incidence of urological complications (81%).
Conclusions:
- Tumor grade does not predict urological complications in sacrococcygeal teratoma.
- Presacral (type IV) teratomas are strongly associated with adverse urological outcomes.
- Recommend early radiographic and neurourodynamic evaluation for all children diagnosed with sacrococcygeal teratoma.
Abstract:
Sacrococcygeal teratoma is the most common extragonadal germ cell tumor of infancy. Associated urological complications, most of which are reported in children with malignancy, include vesicoureteral reflux, ureteral and urethral obstruction, and neurogenic bladder. To evaluate the influence of tumor grade and type on adverse urological outcome we reviewed the charts of 29 children with sacrococcygeal teratoma and correlated urological problems to lesion type and grade. No correlation was noted between tumor grade and the incidence of urological complications. The most common urological complications were neurogenic bladder in 12% of the patients, ureteral obstruction in 10% and vesicoureteral reflux in 7%. The highest incidence of urological complications (81%) was seen in patients with type IV (presacral) disease. We recommend early radiographic and neurourodynamic evaluation in all children with sacrococcygeal teratoma.