Sacrococcygeal Teratoma

Sacrococcygeal teratoma is the tumor arising in sacrococcygeal region.It is the commonest tumor found in newborns. It is also seen in infants, children & very rarely in adults. The SCT is more common in girls than boys with ratio of 3:1. The routine use of prenatal ultrasound has made the diagnosis early during fetal life.

Symptoms:
1. Sacral mass
2. Mass in the abdomen & perineum
3. Distension of abdomen
4. Displacement of anus due to sacral mass
5. Constipation
6. Sacral sinus.

Classification: Altaman's classification
Type 1- Entirely outside
Type 2- Mostly outside
Type 3-Mostly inside
Type 4- Entirely inside

Diagnosis:
1. Prenatal Ultrasound- Solid/ cystic mass occupying abdomen as well as perineum
2. CT Scan abdomino-pelvic region/ MRI abdomino-pelvic region
3. Tumor markers- AFP or Alfafetoproteins

Treatment:
1. Surgical excision in benign or mature teratoma
2. Associated with chemotherapy in malignant or immature teratoma

Chemotherapy:
Bleomycin, Etoposide & Cisplatin (BEP) protocol is the commonest first line protocol used.

Prognosis- Good if complete surgical excision is done along with removal of coccyx.