Abstract
Sacrococcygeal teratomas are extragonadal germ cell tumors that are more commonly found in newborns and infants. This study aims to underscore the importance of considering sacrococcygeal teratomas in the differential diagnosis of presacral mass lesions in adult patients. We retrospectively screened patients who underwent surgical treatment for teratomas between 2011 and 2020. Patients with extraregional sacrococcygeal teratomas, those younger than 18 years of age, and those with incomplete data were excluded from the study. Total excision was performed either through a perineal or abdominal approach, depending on the mass's location. We analyzed and recorded patient data, including age, gender, presenting complaints, MRI findings, Altman classifications, surgical techniques, pathological examination results, and follow-up outcomes. The study included four cases. Among them, three (75%) were female, and the overall average age was 39.5±15.5 years. Three patients presented with a palpable mass, while one patient complained of dysmenorrhea. According to the Altman classification, two patients were classified as Type 2, and two patients as Type 3. Three patients underwent posterior approach surgery, and one patient underwent an abdominal approach. Pathology results confirmed mature teratoma in all cases. No recurrence was observed in any patient during the follow-up period. This study highlights the possibility of encountering sacrococcygeal teratomas in adulthood. It underscores the importance of considering sacrococcygeal teratomas in the differential diagnosis of presacral masses within this age group.
Keywords
References
- Adekola, H., Mody, S., Bronshtein, E., Puder, K., & Abramowicz, J. S. (2015). The clinical relevance of fetal MRI in the diagnosis of Type IV cystic sacrococcygeal teratoma--a review. Fetal and pediatric pathology, 34(1), 31–43. https://doi.org/10.3109/15513815.2014.949934
- Altman, R. P., Randolph, J. G., & Lilly, J. R. (1974). Sacrococcygeal teratoma: American Academy of Pediatrics Surgical Section Survey-1973. Journal of pediatric surgery, 9(3), 389–398. https://doi.org/10.1016/s0022-3468(74)80297-6
- Arceci, R.J., Weinstein, H.J., Avery, G.B., Fletcher, M.A., & McDonald, M.E. (1994). Neonatology: pathophysiology and management of newborn. Lippincott, p:1219-1220.
- Chad A Hamilton, MD; Chief Editor: Jules E Harris, MD , Cystic Teratoma Workup: Medscape Reference; Updated: Jan 17, 2012.
- Danzer, E., Hubbard, A. M., Hedrick, H. L., Johnson, M. P., Wilson, R. D., Howell, L. J., Flake, A. W., & Adzick, N. S. (2006). Diagnosis and characterization of fetal sacrococcygeal teratoma with prenatal MRI. AJR. American journal of roentgenology, 187(4), W350–W356. https://doi.org/10.2214/AJR.05.0152
- Gabra, H. O., Jesudason, E. C., McDowell, H. P., Pizer, B. L., & Losty, P. D. (2006). Sacrococcygeal teratoma--a 25-year experience in a UK regional center. Journal of pediatric surgery, 41(9), 1513–1516. https://doi.org/10.1016/j.jpedsurg.2006.05.019
- Goyal, A., Rathod, P. S., Reddihalli, P. V., Krishnappa, S., Rajshekar, S. K., Kansal, Y., Nuthalapati, S., Singh, A., Vanakudri, T., & Karthik, S. D. S. (2020). A Rare Case of Sacrococcygeal Teratoma in Adult. Indian journal of surgical oncology, 11(Suppl 1), 102–104. https://doi.org/10.1007/s13193-020-01047-0
- Hu, Q., Yan, Y., Liao, H., Liu, H., Yu, H., Zhao, F. Sacrococcygeal teratoma in one twin: a case report and literature review. BMC Pregnancy Childbirth. 2020 Dec 2;20(1):751. doi: 10.1186/s12884-020-03454-1.
- Kremer, M. E., Koeneman, M. M., Derikx, J. P., Coumans, A., van Baren, R., Heij, H. A., Wijnen, M. H., Wijnen, R. M., van der Zee, D. C., & van Heurn, E. L. (2014). Evaluation of pregnancy and delivery in 13 women who underwent resection of a sacrococcygeal teratoma during early childhood. BMC pregnancy and childbirth, 14, 407. https://doi.org/10.1186/s12884-014-0407-x
- Mazreku, A., Karaj, A., Avdia, I., & Bilali, S. (2010). The presentation and management of presacral tumors. Acta chirurgica Iugoslavica, 57(2), 55–59. https://doi.org/10.2298/aci1002055m
- Paramythiotis, D., Papavramidis, T. S., Michalopoulos, A., Papadopoulos, V. N., Apostolidis, S., Televantou, D., & Hytiroglou, P. (2010). Chronic constipation due to presacral teratoma in a 36-year-old woman: a case report. Journal of medical case reports, 4, 23. https://doi.org/10.1186/1752-1947-4-23
- Schropp, K. P., Lobe, T. E., Rao, B., Mutabagani, K., Kay, G. A., Gilchrist, B. F., Philippe, P. G., & Boles, E. T., Jr (1992). Sacrococcygeal teratoma: the experience of four decades. Journal of pediatric surgery, 27(8), 1075–1079. https://doi.org/10.1016/0022-3468(92)90563-m
- Shatnawi, N.J., Khammash, M.R., & Omari, A.H. . A giant sacrococcygeal teratoma in adult female: A case report. Int J Surg Case Rep. 2019;54:47–50. https://doi.org/10.1186/s12893-020-00962-x
- Wakhlu, A., Misra, S., Tandon, R. K., & Wakhlu, A. K. (2002). Sacrococcygeal teratoma. Pediatric surgery international, 18(5-6), 384–387. https://doi.org/10.1007/s00383-002-0729-z
- Xu, X. M., Zhao, F., Cheng, X. F., Zhong, W. X., Liu, J. P., Jiang, W. Q., Yu, X. K., & Lin, J. J. (2019). Adult sacrococcygeal teratoma: a retrospective study over eight years at a single institution. Journal of Zhejiang University. Science. B, 20(8), 670–678. https://doi.org/10.1631/jzus.
Abstract
Sakrokoksigeal teratomlar daha sık yeni doğan ve süt çocukluğu döneminde görülen ekstragonadal yerleşimli germ hücre tümörleridir. Bu çalışmada erişkin hastalarda presakral bölgenin kitlesel lezyonlarında sakrokoksigeal teratomun ayırıcı tanıda düşünülmesi gerektiğine vurgu yapmak amaçlanmıştır. 2011- 2020 tarihleri arasında teratom tanısı ile cerrahi tedavi edilen hastalar geriye dönük olarak tarandı. Sakrokoksigeal bölge dışı teratomu olan, 18 yaşından küçük olan ve çoklu veri eksikliği olan hastalar çalışma dışı bırakıldı Hastaların dosyaları incelenip, yaş, cinsiyet, başvuru şikâyeti, MR bulguları, Altman sınıflamaları, cerrahi yöntemleri, patolojik inceleme ve takip sonuçlarını analiz ederek kaydedildi. Çalışmaya dört olgu dahil edildi. Hastaların üç (%75)’ü kadındı ve genel yaş ortalaması 39.5±15.5 idi. Üç hasta ele gelen kitle, bir hasta dismenore şikâyeti ile başvurdu. Altman sınıflamasına göre iki hasta Tip 2, iki hasta Tip 3 ile uyumluydu. Posterior yaklaşımla üç, abdominal yaklaşımla opere edilen bir hasta bulunuyordu. Patoloji tümünde matür teratom olarak raporlandı. Takip süreçlerinde hiçbir hastada nüks görülmedi. Sakrokoksigeal teratomlara erişkin yaşta da rastlanılabilir. Bu yaş grubu presakral kitle ayırıcı tanısında sakrokoksigeal teratom akılda tutulmalıdır.
Keywords
Supporting Institution
Bu çalışma Başkent Üniversitesi tarafından KA21/92 proje numarası ile desteklenmiştir.
References
- Adekola, H., Mody, S., Bronshtein, E., Puder, K., & Abramowicz, J. S. (2015). The clinical relevance of fetal MRI in the diagnosis of Type IV cystic sacrococcygeal teratoma--a review. Fetal and pediatric pathology, 34(1), 31–43. https://doi.org/10.3109/15513815.2014.949934
- Altman, R. P., Randolph, J. G., & Lilly, J. R. (1974). Sacrococcygeal teratoma: American Academy of Pediatrics Surgical Section Survey-1973. Journal of pediatric surgery, 9(3), 389–398. https://doi.org/10.1016/s0022-3468(74)80297-6
- Arceci, R.J., Weinstein, H.J., Avery, G.B., Fletcher, M.A., & McDonald, M.E. (1994). Neonatology: pathophysiology and management of newborn. Lippincott, p:1219-1220.
- Chad A Hamilton, MD; Chief Editor: Jules E Harris, MD , Cystic Teratoma Workup: Medscape Reference; Updated: Jan 17, 2012.
- Danzer, E., Hubbard, A. M., Hedrick, H. L., Johnson, M. P., Wilson, R. D., Howell, L. J., Flake, A. W., & Adzick, N. S. (2006). Diagnosis and characterization of fetal sacrococcygeal teratoma with prenatal MRI. AJR. American journal of roentgenology, 187(4), W350–W356. https://doi.org/10.2214/AJR.05.0152
- Gabra, H. O., Jesudason, E. C., McDowell, H. P., Pizer, B. L., & Losty, P. D. (2006). Sacrococcygeal teratoma--a 25-year experience in a UK regional center. Journal of pediatric surgery, 41(9), 1513–1516. https://doi.org/10.1016/j.jpedsurg.2006.05.019
- Goyal, A., Rathod, P. S., Reddihalli, P. V., Krishnappa, S., Rajshekar, S. K., Kansal, Y., Nuthalapati, S., Singh, A., Vanakudri, T., & Karthik, S. D. S. (2020). A Rare Case of Sacrococcygeal Teratoma in Adult. Indian journal of surgical oncology, 11(Suppl 1), 102–104. https://doi.org/10.1007/s13193-020-01047-0
- Hu, Q., Yan, Y., Liao, H., Liu, H., Yu, H., Zhao, F. Sacrococcygeal teratoma in one twin: a case report and literature review. BMC Pregnancy Childbirth. 2020 Dec 2;20(1):751. doi: 10.1186/s12884-020-03454-1.
- Kremer, M. E., Koeneman, M. M., Derikx, J. P., Coumans, A., van Baren, R., Heij, H. A., Wijnen, M. H., Wijnen, R. M., van der Zee, D. C., & van Heurn, E. L. (2014). Evaluation of pregnancy and delivery in 13 women who underwent resection of a sacrococcygeal teratoma during early childhood. BMC pregnancy and childbirth, 14, 407. https://doi.org/10.1186/s12884-014-0407-x
- Mazreku, A., Karaj, A., Avdia, I., & Bilali, S. (2010). The presentation and management of presacral tumors. Acta chirurgica Iugoslavica, 57(2), 55–59. https://doi.org/10.2298/aci1002055m
- Paramythiotis, D., Papavramidis, T. S., Michalopoulos, A., Papadopoulos, V. N., Apostolidis, S., Televantou, D., & Hytiroglou, P. (2010). Chronic constipation due to presacral teratoma in a 36-year-old woman: a case report. Journal of medical case reports, 4, 23. https://doi.org/10.1186/1752-1947-4-23
- Schropp, K. P., Lobe, T. E., Rao, B., Mutabagani, K., Kay, G. A., Gilchrist, B. F., Philippe, P. G., & Boles, E. T., Jr (1992). Sacrococcygeal teratoma: the experience of four decades. Journal of pediatric surgery, 27(8), 1075–1079. https://doi.org/10.1016/0022-3468(92)90563-m
- Shatnawi, N.J., Khammash, M.R., & Omari, A.H. . A giant sacrococcygeal teratoma in adult female: A case report. Int J Surg Case Rep. 2019;54:47–50. https://doi.org/10.1186/s12893-020-00962-x
- Wakhlu, A., Misra, S., Tandon, R. K., & Wakhlu, A. K. (2002). Sacrococcygeal teratoma. Pediatric surgery international, 18(5-6), 384–387. https://doi.org/10.1007/s00383-002-0729-z
- Xu, X. M., Zhao, F., Cheng, X. F., Zhong, W. X., Liu, J. P., Jiang, W. Q., Yu, X. K., & Lin, J. J. (2019). Adult sacrococcygeal teratoma: a retrospective study over eight years at a single institution. Journal of Zhejiang University. Science. B, 20(8), 670–678. https://doi.org/10.1631/jzus.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Olgu sunumu |
| Authors | |
| Publication Date | April 25, 2025 |
| Submission Date | June 1, 2023 |
| Acceptance Date | October 3, 2023 |
| Published in Issue | Year 2025 Volume: 7 Issue: 1 |
Journal of General Health Sciences is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).