- All Journals
- Al-Qadisiyah University
- Basrah University
- Kirkuk University
- Mosul University
- The Iraqi Borad for Medical Specialization
- University of Anbar
- University of Technology
- Al Mustafa University
- Al-Zahraa University for Women
- Alnoor University
- Kunooz University
- Misan University
- Ninevah University
- Tikrit University
- University of Al-Hamdaniya
- University of Kerbala
The Outcome of Sacrococcygeal Teratoma: A Multicenter Study in Iraq | ||
| Al- Anbar Medical Journal | ||
| Article 7, Volume 17, Issue 1, 2021, Pages 30-34 PDF (624.04 K) | ||
| Document Type: Original articles | ||
| DOI: 10.33091/amj.2021.171062 | ||
| Authors | ||
| Saad S Yousif .1; Arkan H Ahmad .* 2 | ||
| 1Department of Pediatrics Surgery, Al-Khanssa Teaching Hospital, Nineveh Health Directorate, Mosul, Nineveh, Iraq. | ||
| 2Department of Pediatrics Surgery, Al-Ramadi Maternity and Children Teaching Hospital, Anbar Health Directorate, Anbar, Iraq. | ||
| Abstract | ||
| Background: Sacrococcygeal teratoma (SCT) is one of the most common solid tumors in theneonate. They are more common in females and presented as sacral masses. They require an earlysurgical resection with regular follow-up.Objectives: To evaluate the SCTs regarding the perinatal variables, clinical characters, pathological features, management options, and outcome.Materials and methods: A prospective study of 37 patients with SCTs were admitted topediatric surgery departments in Ramadi (west of Iraq) and Mosul city (north of Iraq) during theperiod from December 2013 to December 2018. The detailed data of each patient were recordedand analyzed including history, physical examination, investigations, management, and follow-up.Results: There were 23 (62%) females and 14 (38%) males. The ages were ranged from 1 dayto 2 years. Fifty-one percent were diagnosed prenatally by ultrasound and 30% of them weredelivered by Caesarean section. Among the neonatal age group (28 patients),75% were born at fullterm, their median birth weight was 3100 g. Associated anomalies were 3%. Plain X-ray of thetumors was revealed calcification in 22%. The serum α-fetoprotein level was high at presentation.According to Altman classification, there were type I 54%, type II 40%, type III 3%, and type IV3%. Ninety-seven percent was presented as sacral mass and only 3% was presented with urinarytract obstruction. One (3%) was died a few hours after labor due to the rupture of the tumor.Surgical intervention was performed in 94% of patients. Macroscopically, 59% were mixed, 22%solid, and 19% cystic. Histologically, 92% had mature teratoma, 3% immature, and 6% malignantteratoma. Wound infection occurred in 10%, wound dehiscence in 3%, and poor cosmetic scar in8%. One (3%) patient had a recurrence.Conclusion: The proper management are important factors affecting the outcome in the perinatalperiod and early diagnosis with complete excision of the tumor. The size of the primary tumordoes not affect the recurrence and the outcome | ||
| Keywords | ||
| Sacrococcygeal teratoma; Neonatal tumors; Outcome | ||
| References | ||
|
[1] R. P. Altman, J. G. Randolph, and J. R. Lilly, “Sacrococcygeal teratoma: American Academy of Pediatrics surgical section survey—1973,” J. Pediatr. Surg., vol. 9, no. 3, pp. 389–398, 1974.
[2] F. J. Rescorla, “Teratomas and other germ cell tumors,” in Pediatric surgery, Elsevier Inc., 2012, pp. 507–516.
[3] J.-M. Laberge, “Teratomas, dermoids, and other soft tissue tumors,” Pediatr. Surg., 2000.
[4] L. B. Chirdan, A. F. Uba, S. D. Pam, S. T. Edino, B. M. Mandong, and O. O. Chirdan, “Sacrococcygeal teratoma: Clinical characteristics and long-term outcome in Nigerian children,” Ann. Afr. Med., vol. 8, no. 2, 2009.
[5] R. Swamy, N. Embleton, and J. Hale, “Sacrococcygeal teratoma over two decades: birth prevalence, prenatal diagnosis and clinical outcomes,” Prenat. Diagnosis Publ. Affil. With Int. Soc. Prenat. Diagnosis, vol. 28, no. 11, pp. 1048–1051, 2008.
[6] H. O. Gabra, E. C. Jesudason, H. P. McDowell, B. L. Pizer, and P. D. Losty, “Sacrococcygeal teratoma—a 25-year experience in a UK regional center,” J. Pediatr. Surg., vol. 41, no. 9, pp. 1513–1516, 2006.
[7] J. KOURANLOU, N. Sadeghian, and A. R. Mirshemirani, “Benign sacrococcygeal teratoma: A fifteen-year retrospective study,” 2006.
[8] S. H. Ein, S. D. Adeyemi, and K. Mancer, “Benign sacrococcygeal teratomas in infants and children: a 25 year review.,” Ann. Surg., vol. 191, no. 3, p. 382, 1980.
[9] J. P. M. Derikx et al., “Factors associated with recurrence and metastasis in sacrococcygeal teratoma,” Br. J. Surg., vol. 93, no. 12, pp. 1543–1548, 2006.
[10] K. A. E. Aly, M. Shoier, and T. Badrawy, “Sacrococcygeal teratoma: a neonatal surgical problem,” Ann Pediatr Surg, vol. 2, no. 2, pp. 106–111, 2006.
[11] L. K. R. Shanbhogue, A. Bianchi, C. M. Doig, and D. C. S. Gough, “Management of benign sacrococcygeal teratoma: reducing mortality and mornidity,” Pediatr. Surg. Int., vol. 5, no. 1, pp. 41–44, 1990.
[12] M. Hambraeus, E. Arnbjörnsson, A. Börjesson, K. Salvesen, and L. Hagander, “Sacrococcygeal teratoma: a population-based study of incidence and prenatal prognostic factors,” J. Pediatr. Surg., vol. 51, no. 3, pp. 481–485, 2016.
[13] D. K. Yadav, S. K. Acharya, D. Bagga, V. Jain, A. Dhua, and P. Goel, “Sacrococcygeal teratoma: Clinical characteristics, management, and long-term outcomes in a prospective study from a Tertiary Care Center,” J. Indian Assoc. Pediatr. Surg., vol. 25, no. 1, p. 15, 2020.
[14] M. E. B. Kremer et al., “The incidence of associated abnormalities in patients with sacrococcygeal teratoma,” J. Pediatr. Surg., vol. 53, no. 10, pp. 1918–1922, 2018.
[15] W. Yao, K. Li, S. Zheng, K. Dong, and X. Xiao, “Analysis of recurrence risks for sacrococcygeal teratoma in children,” J. Pediatr. Surg., vol. 49, no. 12, pp. 1839–1842, 2014.
| ||
|
Statistics Article View: 530 PDF Download: 360 |
||