Sacrococcygeal teratoma, Type III

Miguel Octavio Sosa Palaviccini, MD Daniel Chirinos, MD

Hospital Antonio M. Pineda, Barquisimeto, Venezuela

This is the first pregnancy of a 29-year-old patient. Her 8 previous ultrasonograms elsewhere had been reported as normal aside from the last exam that suspected bright bowel. This examination was performed at 39 weeks. The large subdiaphragmatic mass extends caudally to the sacrococcygeal zone. It is very heterogeneous with echogenic zones alternating with fluid-filled zones. The vertebral bodies were normal. There was bilateral hydronephrosis.

Skin edema at the level of the skull:

1A

Sagittal view:  left side of tumor (extracorporeal zone of teratoma), right side: intra abdominal extention )

11A

  

Vertebral body at 5 o"clock . Transversal section of upper abdomen, non-visible stomach

12A

   

Left side: extension in the abdomen, right side: size of thorax
 

5A


Renal compression by the tumor

14A

   


 Pyelectasis in longitudinal section

16A

    
Renal pelvis with dilatation

17A
7A

 Transverse sections of both kidneys   

9A

End of spine

18A
3A

Close up of end of spine

4A

Multiples cavities inside the tumor

8A

The teratoma does not permit to identify genitalia or anus

6A

Cardiothoracic disproportion due to oligoamnios, pulmonary hypoplasia

2A

The newborn was delivered by cesarean section and weighted 4200 g and 56 cm of long. She presented with facial skin with edema. The baby went into respiratory distress and died 30 minutes after birth. The parents gave the newborn for pathological study. The autopsy confirmed a type III sacrococcygeal teratoma.

Facial edema

1B

The end of the spine


3B

 Close up of end of spine

4B

The teratoma compresses the anogenital region
 

6B

Thoraco-abdominal disproportion

5B

 

Lateral view of the fetus (sliced)

8B


Right fetal hemibody


19A

End of the spine

18B

The internal component of the teratoma is 3 times longer than external component

16B

Compressed diaphragm by the subphrenic teratoma  

12B

 

External portion of the teratoma

13B


Renal pelvis dilatation

14B
17B

The right kidney

9B

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