Management of Sacrococcygeal Pertoma in Neonates (Report of 4 Cases)

Sarcococcygel teratomy is the most common: solid neoplasm in neonates. Diagnosis is based on clinical findings, radiographic, and tumor markers. Most of them are benign, with early surgical clinical finding, radiographic, and tumor markers. Most of them are benign, with early surgical excision as the adequate therapy, while the immature type requires further chemotherapy with poorer prognosis. Four term babies were referred to Soetomo Hospital with mass on sacral region. Clinical, radiographic,and laboratory work-ups supported the suspected teratoma. Alpha feto protein was examined in 3 cases and all were elevated. Beta-HCG was elevated in case 4. Two of the masses ruptured and urgently excised, while the other 2 underwent elective operation. Th surgical intervention consisted of tumor excision, coccygectomy, and legation of sacroiliac artery, all performed before age of 1 month. Cases 1,2, and 3 was classified as type 1 according to American Academy Pediatric Surgical Section (AAPSS) calssification. Histopathology examination on 3 cases revealed mature teratoms, while in case 4 revealed grade 2 immature. Tumor markers decrement were noticed after the operation, However, in Case 4 the AFP level was still high. Case 4 was planned for further chemotherapy. Four cases of sacrococcygeal leratomas in neonates were reported. Tumor markers, radiographic evaluation, and early surgical interventions were performed. One cases had poor prognosis due to immature grading and refusal of chemotherpy.