Techniques available for the management of massive sacrococcygeal teratomas

An infant born in the 34th week of gestation weighing 5,355 g with a massive sacrococcygeal (SC) tumor was delivered by elective cesarean section. An ultrasonographic examination showed solid and cystic components in the tumor. Resection was successfully undertaken with insertion of a Nelaton catheter into the rectum to avoid unnecessary impairment of the viscera. The tumor weighed 2,380 g, measured 25 × 14 × 11 cm, and was clinicopathologically diagnosed to be a SC teratoma. This experience and other publications show that several considerations including control of hemorrhage and coagulopathies, visceral protection, and avoidance of wound infection are necessary to facilitate the surgical management of massive SC tumors. Several suggestions are made concerning the pre- and intraoperative management of this rare tumor.