Sacrococcygeal teratoma
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Natural history, Complications, and Prognosis
Differentiating Sacrococcygeal teratoma from other Diseases
Diagnosis
History & Symptoms
Physical Examination
Lab tests
Echocardiography or Ultrasound
Surgery
Treatment
The preferred first treatment for SCT is complete surgical removal (ie, complete resection). The preferred approach to a small SCT is through the perineum; a large SCT may require an additional approach through the abdomen. Resection should include the coccyx and may also include portions of the sacrum. The surgery should include reattachment of the small muscles and ligaments formerly attached to the coccyx, in effect reconstructing the posterior perineum.
SCTs are classified morphologically according to how much of them is outside or inside the body:
- Altman Type I — entirely external, sometimes attached to the body only by a narrow stalk
- Altman Type II
- Altman Type III
- Altman Type IV — entirely internal; this is a presacral teratoma
The Altman Type has a significant influence on management, surgical approach, and complications of SCT. Serial ultrasound and MRI monitoring of SCTs in fetuses in utero has demonstrated that the Altman Type can change over time.
Regardless of location in the body, teratomas are classified according to a cancer staging system. This indicates whether chemotherapy or radiation therapy may be needed.
Management of fetal SCTs
Complications
See also
References
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