Adult sacrococcygeal teratoma: a retrospective study over eight years at a single institution

Abstract

Objective

To determine the clinical, imaging, and histological features, and surgical resection modalities and outcomes of adult sacrococcygeal teratoma (SCT).

Methods

Adult patients with histopathologically diagnosed SCT were enrolled in our hospital between August 2010 and August 2018. Each patient’s characteristics and clinical information were reviewed.

Results

There were 8 patients in the study (2 males, 6 females) with a median age of 34 years (range, 18–67 years). The time to clinical symptoms was 14 d to 35 years, with a median time of 4 years. Six patients presented with symptoms of sacrococcygeal pain, and four with signs of sacrococcygeal mass and ulceration in the sacrococcygeal region. Six patients were evaluated using a combination of computed tomography (CT) and magnetic resonance imaging (MRI). All patients showed a presacral tumor with heterogeneous intensity on CT images. All patients underwent surgical treatment, including 6 parasacral, 1 transabdominal, and 1 combined anterior-posterior surgery cases. Seven patients were histopathologically diagnosed with benign mature SCT, and have shown no recurrence. One patient had malignant SCT, with recurrence at 84 months after surgery. After a second surgery, the patient had no recurrence within 6 months follow-up after re-resection.

Conclusions

Our retrospective study demonstrated: (1) adult SCT is difficult to diagnose because of a lack of typical clinical symptoms and signs; (2) a combination of CT and MRI examination is beneficial for preoperative diagnosis; (3) the choice of surgical approach and surgical resection modality depends on the size, location, and components of the tumor, which can be defined from preoperative CT and MRI evaluation; (4) most adult SCTs are benign; the surgical outcome for the malignant SCT patient was good after complete resection. Even for the patient with recurrent malignant SCT, the surgical outcome was good after re-resection.

抽象

目 的

探讨成人骶尾部畸胎瘤的临床表现、影像学特点、 组织学特征、手术方式及预后。

方 法

回顾分析2010年8月至2018年8月在我院收治经组 织病理学诊断为骶尾部畸胎瘤患者的临床资料。

结 果

本组患者病例 8 例 (男2 例, 女6 例), 中位年 龄 34 岁。 6 例患者表现为骶尾部疼痛, 4 例表现 为骶尾部肿块和溃疡。 采用计算机断层扫描 (CT) 和磁共振成像 (MRI) 相结合的方法进行评估, 所有患者均进行手术治疗。 7 例经病理诊断为良 性畸胎瘤, 术后无复发。 1 例为恶性畸胎瘤, 术 后 84 个月复发, 二次手术后随访 6 月无复发。

结 论

(1) 由于缺乏典型的临床表现, 成人骶尾部畸 胎瘤难以诊断; (2) CT 和 MRI 检查相结合有利 于术前诊断; (3) 手术入路和手术切除方式的 选择取决于肿瘤的大小、位置和组成,可以通过 术前的CT 和MRI 来确定; (4) 大多数成年骶 尾部畸胎瘤是良性的, 恶性畸胎瘤手术切除效果 良好。 即使对于复发性恶性畸胎瘤, 再次手术效 果良好。