Saccrococcygeal teratoma
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Primordial germ cells migrate during fetal development and can become arrested, resulting in extragonadal germ cell tumors like sacrococcygeal teratomas. Sacrococcygeal teratomas are the most common extragonadal germ cell tumors in neonates, occurring more frequently in females. They may be partially or completely external (Altman types I and II) or primarily internal with extension into the pelvis or abdomen (types III and IV). Complete surgical excision including coccygectomy is the primary treatment, with chemotherapy for malignant histology, and alpha-fetoprotein monitoring post-surgery to detect recurrence.
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Sacrococcygeal teratoma
This document discusses sacrococcygeal teratoma (SCT), a type of germ cell tumor that most commonly affects newborns and infants. SCTs arise from abnormal fetal germ cells and contain tissues from all three germ layers. They commonly present as a mass in the sacrococcygeal region and may be benign or malignant. Treatment involves complete surgical resection of the tumor along with chemotherapy for malignant varieties. Prognosis is generally good if the tumor can be completely resected, though recurrence is possible.
sacrococcygeal teratoma
This document discusses sacrococcygeal teratoma (SCT), a rare congenital tumor. SCT arises from embryonic cells and can be benign or malignant. It presents prenatally via ultrasound in most cases. Risk of malignancy increases with age of diagnosis. Treatment involves complete surgical excision, with early surgery associated with better outcomes. Large or rapidly growing tumors may require intervention like chemotherapy or early delivery to prevent complications of high output cardiac failure. Complete resection remains the main treatment for benign SCT to prevent malignant transformation.
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Sacrococcygeal teratoma
This document discusses sacrococcygeal teratoma (SCT), a type of germ cell tumor that most commonly affects newborns and infants. SCTs arise from abnormal fetal germ cells and contain tissues from all three germ layers. They commonly present as a mass in the sacrococcygeal region and may be benign or malignant. Treatment involves complete surgical resection of the tumor along with chemotherapy for malignant varieties. Prognosis is generally good if the tumor can be completely resected, though recurrence is possible.
sacrococcygeal teratoma
This document discusses sacrococcygeal teratoma (SCT), a rare congenital tumor. SCT arises from embryonic cells and can be benign or malignant. It presents prenatally via ultrasound in most cases. Risk of malignancy increases with age of diagnosis. Treatment involves complete surgical excision, with early surgery associated with better outcomes. Large or rapidly growing tumors may require intervention like chemotherapy or early delivery to prevent complications of high output cardiac failure. Complete resection remains the main treatment for benign SCT to prevent malignant transformation.
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This document provides information on ovarian tumors, including normal ovarian anatomy and function, differential diagnosis of adnexal masses, classification of ovarian neoplasms, clinical presentation, evaluation, and management of ovarian cysts and masses. Key points include:
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Solid pediatric tumour - wilms,neuroblastoma,hepatoblastoma, GCT
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Saccrococcygeal teratoma
- 2. Teratomas are germ cell tumors commonly composed of multiple cell types derived from one or more of the 3 germ layers. Teratomas range from benign, well-differentiated (mature) cystic lesions to those that are solid and malignant (immature)
- 3. Primordial germ cells arise near the allantois of the embryonic yolk sac endoderm and are evident at the fourth fetal week.
- 4. Migrate Along The Midline Dorsal Mesentery To The Genital Ridge, Arriving By The End Of The Sixth Fetal Week.
- 5. Mediated by the c-KIT receptor and stem cell factor • Arrested migration - extragonadal locations in the normal path of the germ cells – retroperitoneum • Aberrant migration results in cells at other extragonadal sites - pineal, sacrococcygeal
- 6. In adults - 90% of germ cell tumors are at gonadal locations. • Abnormal or arrested migration of primordial germ cells results in deposition in sacrococcygeal region, retroperitoneum, mediastinum, and pineal gland of the brain – EXTRAGONADAL GERM CELL TUMORS.
- 7. • Majority tumor are benign and extragonadal. • Yolk sac tumor is the predominant malignant histology. • Serum marker (alpha fetoprotein, AFP) exists to follow response to therapy and monitor for recurrent disease. • Cisplatin and Bleomycin responsive t/t
- 9. Sacrococcygeal teratomas [SCT] are the M/C extragonadal tumor in neonates, [70% of all teratomas in childhood] MORE IN FEMALE BABIES.
- 10. PRESENTATION- Neonates with large predominantly external lesions, which are detected in utero or at birth older infants and children who present with primarily hidden pelvic tumors with a much higher rate of malignancy • In-utero shunting can lead to fetal hydrops, which is associated with high mortality.
- 11. Altman Types- Type I (46.7%)- External Predominantly. Type II (34%)- External With Intrapelvic Extension. Type III (8.8%) Visible Externally But Predominantly Pelvic And Abdominal Type IV (9.8%) Entirely Presacral. Malignancy Rate Increased With The More Hidden (Type III And IV) Lesions
- 12. D/D • Meningomyelocele • Infantile Hamartoma • Dermoid • Osteomyelitis Of Sacrum • Neuroenteric Cyst • Currarino Triad- Presacral teratoma Anal Stenosis Sacral Defects
- 13. • Ultrasonography • CT • Magnetic resonance imaging (MRI)
- 14. Surgical Mx • Removal of the coccyx is an essential step, because 37% recurrence if left.
- 17. Surgical steps Highlights • chevron incision • gluteus maximus dissection & sacrum and coccyx identification • En bloc removal of tumor with coccygectomy
- 18. • Pelvic floor reconstruction • Skin closure
- 19. Followup • malignant germ-cell tumors can recur either incomplete resection or from malignant conversion of benign residual tissue. • Chemotherapy if malignant histology • AFP monitoring
- 20. • AFP levels- produced by embryonic yolk sac and the fetal liver • normally elevated in 1mnth of age, return to normal by 9 months age.[less than 10 ng/mL] • Goal of any treatment is to return AFP to normal levels. Tumor recurrence - sudden elevation of the AFP level. • Half Life- 5-7days
- 21. Thank you