Sacrococcygeal Teratoma – a single center study of 43 years (1968–2011) including follow-up data and histopathological reevaluation of specimens

BACKGROUND: Sacrococcygeal teratomas (SCTs) are neoplasms, which are mostly categorized as benign at birth. If not resected short after birth, malignant transformation can occur in a timely manner. Moreover, timely resected and benign classified SCTs may reoccur years later as malignant relapse. Finally SCTs can cause several intrauterine and/or postoperative complications which can alter the patients for lifetime. METHODS: Between January 1968 and December 2011 29 children underwent surgical interventions due to SCT at our Department. One additional, primarily outward treated girl was operated due to a malignant relapse. Clinical records of 24 patients (all survived) and of the girl with the relapse (who died 7 months after second intervention) were accessible. A complete clinical follow-up including optional multidisciplinary examinations was carried out, possible in 16 patients, of whom one girl had malignant relapse. A comparison among three of the most common histological classifications of SCT was made using the histology available of the 25 mentioned patients. RESULTS: Except for incontinence problems in four patients and dissatisfaction with scar formation in 5 cases, the results were surprisingly good. Histological reevaluation showed no differences between the classifications. CONCLUSIONS: Despite the heterogeneity of treatment within the last 43 years, all 24 "own" patients survived. The 16 re-examined patients showed no significant complaints. Histological grading of SCTs is comparable even using different classification systems and does not affect survival rate. Despite accurate resection, annual control investigations should be offered to all patients harboring SCTs, because late recurrence cannot be easily predicted yet.