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Sacrococcygeal teratomas: a case-based review from the perspective of individual multidisciplinary experts

  • Case-based Review
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Abstract

Purpose

Sacrococcygeal teratoma (SCT) is a rare congenital tumor originating from a variant of extragonadal germ cell neoplasm. Herein, we present three cases of neonatal SCTs undergoing surgical resection and reconstruction. We also review the literature to discuss the importance of proper perinatal management and timely surgical intervention depending on the tumor type and maturity to prevent malignant transformation and recurrence and ensure functional outcomes.

Methods and results

Three cases of SCT were retrospectively analyzed. All infants underwent complete surgical resection of the SCT and coccygectomy during their neonatal/infancy period, followed by pelvic floor and buttock reconstruction while minimizing buttock contour deformity and undesirable skin scar. Two of the cases were histopathologically diagnosed as predominantly cystic mature teratomas of Altman types I and IV, and the third was a mature teratoma of Altman type II. There were no complications or tumor recurrence during the average follow-up period of 5.3 years.

Conclusions

This case-based review highlights the role of multidisciplinary team approaches, including prenatal monitoring, oncologic resection, and adequate reconstruction according to the type of tumor and anomaly. Optimal perinatal evaluation allows promising oncologic and functional outcomes in terms of timely intervention to eliminate tumor recurrence and malignant transformation. Complete oncologic surgical resection of SCTs should also include proper functional preservation strategies, such as the reconstruction of the pelvic floor, cosmetic buttock contouring, and preservation of bladder and bowel sphincter function.

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Funding

This research was supported by the Basic Science Research Program of the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Korea (grant no. NRF‐2020R1I1A3073930).

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Authors and Affiliations

  1. Department of Neurosurgery and Neuroscience & Radiosurgery Hybrid Research Center, College of Medicine, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-Gu, Goyang, Gyeonggi Province, 10380, Korea

    Mohammad Mohsen Mosleh & Moon-Jun Sohn

  2. Department of General Surgery, College of Medicine, Inje University Ilsan Paik Hospital, 170 Juhwa-ro, Ilsanseo-Gu, Goyang, Gyeonggi Province, 10380, Korea

    Tae Gil Heo

  3. Division of Pediatric Surgery, Department of Surgery, Jeonbuk National University Medical School, 20, Geonjiro, Deokjin-Gu, Jeonju, Jeollabuk-do, 54907, Korea

    Hyun Beak Shin

Authors
  1. Mohammad Mohsen Mosleh
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  2. Tae Gil Heo
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  4. Moon-Jun Sohn
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Contributions

M-JS and TGH conceptualized the study design. MMM and TGH reviewed the medical records for three patients and the existing literature. MMM and HBS prepared the first draft of the manuscript. All authors reviewed the draft and approved the final manuscript for publication.

Corresponding author

Correspondence to Moon-Jun Sohn.

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Ethics approval and consent to participate

This study was reviewed and approved by the Institutional Review Board of Inje University Ilsan Paik Hospital (No. 2022–06-012), and informed consent was obtained from all participants.

Consent for publication

Parental consent was obtained for all patients included in the study regarding the publication of personal medical data and pictures.

Conflict of interest

The authors declare that they have no competing interests.

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Mosleh, M.M., Heo, T.G., Shin, H.B. et al. Sacrococcygeal teratomas: a case-based review from the perspective of individual multidisciplinary experts. Childs Nerv Syst 39, 57–64 (2023). https://doi.org/10.1007/s00381-022-05768-1

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