Sacrococcygeal teratoma classification: Difference between revisions

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==Overview==
==Overview==
'''Sacrococcygeal teratoma''' (SCT) is classified into 4 different categories according to American Academy of Pediatrics Surgery classification.<ref name = "class">Puri P, Höllwarth ME. Pediatric Surgery, Diagnosis and Management. Springer Science & Business Media; 2009.</ref><ref name = "cs">Myers LB, Bulich LA. Anesthesia for Fetal Intervention and Surgery. PMPH-USA; 2005.</ref>
Sacrococcygeal teratoma is [[Classification|classified]] into four different categories according to the American academy of pediatrics surgery classification based upon the [[Anatomy|anatomical]] location of the [[tumor]]. Sub-types of sacrococcygeal teratoma have different [[Cancer staging|staging]] systems based on the size and growth of the [[tumor]], [[lymph node]] involvement, and the presence of [[metastasis]].


==Classification==
==Classification ==
American Academy of Pediatrics Surgery Section System classifies Sacrococcygeal teratoma depending on the anatomical location of the tumor.
*Type I - extensively exterior with minimal pelvic involvement.<ref name = "class">Puri P, Höllwarth ME. Pediatric Surgery, Diagnosis and Management. Springer Science & Business Media; 2009.</ref><ref name = "cs">Myers LB, Bulich LA. Anesthesia for Fetal Intervention and Surgery. PMPH-USA; 2005.</ref>
*Type II - has pelvic involvement giving tumorous growth an "hour-glass" appearance.
*Type III - has more pelvic and intra-abdominal involvement than external.
*Type IV - extensive pre-sacral involvement without external growth.


==Staging of Sacrococcygeal Teratoma==
=== Classification Based Upon Anatomical Location ===
*I - Complete resection; negative tumor margins<ref name = "stage">DeVita VT, Lawrence TS, Rosenberg SA. DeVita, Hellman, and Rosenberg's Cancer, Principles & Practice of Oncology. Lippincott Williams & Wilkins; 2008.</ref>
American academy of pediatrics surgery section system [[Classification|classifies]] sacrococcygeal teratoma depending on the [[Anatomy|anatomical]] location of the [[tumor]]. <ref name="class">Puri P, Höllwarth ME. Pediatric Surgery, Diagnosis and Management. Springer Science & Business Media; 2009.</ref><ref name="cs">Myers LB, Bulich LA. Anesthesia for Fetal Intervention and Surgery. PMPH-USA; 2005.</ref>
*II - Microscopic residuals; lymph node negative
*III - Lymph node involvement; Gross residual on biopsy; retroperitoneal node may be positive or negative
*IV - Distant metastasis may involve liver


==Grade==
{| style="border: 0px; font-size: 90%; margin: 3px; width: 800px"
According to Gonzalez-Crussi System, Sacrococcygeal teratoma is graded on a scale from 0-3, based on the histology:<ref name = "cs">Myers LB, Bulich LA. Anesthesia for Fetal Intervention and Surgery. PMPH-USA; 2005.</ref>
| valign="top" |
|+
! style="background: #4479BA; width: 100px;" | {{fontcolor|#FFF|Stage  }}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Features}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
'''Type I'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Predominantly external; with minimal [[Pelvis|pelvic]] involvement
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
'''Type II'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Predominantly external; with significant [[Pelvic|intrapelvic]] growth giving "hour-glass" appearance
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
'''Type III'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Predominantly internal; with [[Abdomen|intra-abdominal]] involvement
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
'''Type IV'''
| style="padding: 5px 5px; background: #F5F5F5;" |
*Entirely pre-[[Sacrum|sacral]]; without external growth
|}


*Grade 0-Tumour contains only mature tissue.
===Classification Based Upon Pathology===
*Grade 1-Tumour contains rare foci of immature tissues; <10%
*'''Benign''' : Mature<ref name="class">Sacrococcygel Teratoma. Radiopedia (2015) http://radiopaedia.org/articles/sacrococcygeal-teratoma Accessed on December 15, 2015</ref>
*Grade 2-Tumour contains moderate quantities of immature tissues.(10-50%)
*'''Malignant''' : Immature
*Grade 3-Tumour contains large quantities of immature tissue with or without malignant yolk sac elements.(>50%)


==References==
==References==
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]

Overview

Sacrococcygeal teratoma is classified into four different categories according to the American academy of pediatrics surgery classification based upon the anatomical location of the tumor. Sub-types of sacrococcygeal teratoma have different staging systems based on the size and growth of the tumor, lymph node involvement, and the presence of metastasis.

Classification

Classification Based Upon Anatomical Location

American academy of pediatrics surgery section system classifies sacrococcygeal teratoma depending on the anatomical location of the tumor. [1][2]

Stage Features

Type I

  • Predominantly external; with minimal pelvic involvement

Type II

  • Predominantly external; with significant intrapelvic growth giving "hour-glass" appearance

Type III

Type IV

  • Entirely pre-sacral; without external growth

Classification Based Upon Pathology

  • Benign : Mature[1]
  • Malignant : Immature

References

  1. 1.0 1.1 Puri P, Höllwarth ME. Pediatric Surgery, Diagnosis and Management. Springer Science & Business Media; 2009.
  2. Myers LB, Bulich LA. Anesthesia for Fetal Intervention and Surgery. PMPH-USA; 2005.

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