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Abstract

 BACKGROUND:Sacrococcygeal teratoma is the most common tumor in the newborn.. Approximately 90% ofsacrococcygeal teratomas excised during the neonatal period are benign. The risk of malignancy increasesin lesions removed after 6 months of age.OBJECTIVE::To discuss the management of newborns with sacrococcygeal teratomas and the importance of earlysurgical intervention in avoiding the risk of malignant transformation.PATIENTS AND METHODS:11 neonates with sacrococcygeal teratomas were managed during the period from April 2008 throughApril 2013. In all cases, age, sex, mode of delivery, details of surgery, extent of resection, macroscopictumor appearance, tumor histology, Altman classification and postoperative morbidity and mortality wereall documented and analyzed. A two years follow up plan was designed to assess any complication andtumor recurrence.RESULTS:Classical sacrococcygeal approach was performed in all of the patients operated upon and completeexcision of the tumor along with the coccyx was possible in all cases. According to the Altmanclassification 8 (72.7%) of the tumors were of type I. Macroscopically, 7(63.6%) tumors were mixed,.Histopathological examination of the excised tumors revealed the diagnosis of benign mature teratoma inall cases. All of the newborns survived with the exception of one patient with a giant sacrococcygealmass who died because of heart failure . No tumor recurrence was documented in all of the patientsoperated on.CONCLUSION:Early detection including antenatal diagnosis is essential to define fetuses with poor prognostic signs anddeciding the appropriate mode of delivery, and in some centers even fetal intervention. Early excision ofthese tumors during the neonatal period is essential to avoid the risk of malignant transformation.

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