Prenatal sonographic diagnosis of congenital sacrococcygeal teratoma and management

Teratomas are tumors containing tissues derived from all three germinal cell layers. Most teratomas arise in the sacrococcygeal region, with a reported incidence of 1/40,000 births. During labor, severe dystocia may occur in infants with large tumors if delivered vaginally, with an extremely high fetal morbidity and mortality rate. Reported is a case of a large congenital sacrococcygeal teratoma diagnosed antepartum by sonography at 36 weeks pregnancy. This sonographic finding allowed us to avoid traumatic delivery. Cesarean section was performed, with the delivery of a 4.050-g female infant with a large sacrococcygeal tumor. Resection of the sacral mass was performed on the 5th day of life. Pathologic examination showed a mature sacrococcygeal teratoma weighing 620-g, and measuring 14-cm by 11-cm by 9-cm. The infant had an uneventful recovery. This report agrees with previous reported cases in which successful management of sacrococcygeal teratomas could be achieved with accurate prenatal diagnosis, atraumatic delivery, and prompt surgical intervention. The role of sonography in the management of these cases is stressed.