WHAT IS SACROCOCCYGEAL TERATOMA (SCT)? ALL ABOUT IT'S CAUSES SYMPTOMS PATHOLOGY DIAGNOSIS TREATMENT
4.6 هزار بار بازدید -
4 سال پیش
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It is a teratoma derived
It is a teratoma derived from a primitive streak derivative and arises at the base of coccyx and sacrum.
The tumour is composed of the all three germ cells (i.e. ectoderm, mesoderm and endoderm).
It is the most common congenital germ cell tumor diagnosed in infants and children younger than 4 years.
Incidence: 1 in 35,000-40,000 live births.
F: M 3:1-4:1 ratio
It is more common in girls
Classification is given be Altman and is as follows
TYPE 1 - Entirely exophytic.
TYPE 2 - Nearly entirely exophytic.
TYPE 3 - Mostly to the inside.
TYPE 4 - Entirely inside. Also called retrorectal teratoma or presacral teratoma
The Currarino triad , due to an autosomal dominant mutation in the MNX1 gene, consists of a presacral mass (usually a mature teratoma or anterior meningocele), anorectal malformation and sacral dysgenesis.
Symptoms can be a presacral mass, constipation, urinary difficulties, bowel obstruction, hydronephrosis and so on
A solid or cystic mass on prenatal ultrasound and growing internally or externally.
Other tumors can occur in the sacrococcygeal and/or presacral regions and hence must be ruled out to obtain a differential diagnosis. These include extraspinal ependymoma, ependymoblastoma, neuroblastoma and rhabdomyosarcoma.
If baby’s condition is stable with no high output cardiac failure (fetal hydrops), pregnancy will be followed with regular ultrasound monitoring. If the SCT is small, a vaginal delivery at term may be planned.
If the SCT is large or if there is an excess of amniotic fluid (polyhydramnios), an early cesarean section is planned to avoid tumor rupture as well as the risks of preterm labor and premature delivery.
If fetal hydrops develops, it may be a candidate for fetal surgery.
In cases with extreme fetal hydrops, the mother may be at risk for maternal mirror syndrome, in which the mom’s condition parallels & mimics that of the sick fetus. When fetal hydrops is present, the mother may "mirror" the sick fetus, becoming ill with signs of preeclampsia. Because of a hyperdynamic cardiovascular state, the mother develops symptoms that are similar to pre-eclampsia and may include vomiting, hypertension, peripheral edema (swelling of the hands and feet), proteinuria (protein in the urine), and pulmonary edema (fluid in the lungs). Despite resection of the fetal SCT, maternal mirror syndrome may still occur.
Preeclampsia, also called toxemia, is a condition characterized by pregnancy-induced high blood pressure, protein in the urine, and swelling due to fluid retention.
Complete surgical removal after birth through a perineal or abdominal approach. The preferred approach to a small SCT is through the perineum; a large SCT may require an additional approach through the abdomen.
The procedure includes resection of the involved parts of coccyx and sacrum and reattachments of the muscles that are attached to these bony segments in the usual cases. If not, there is an increased risk of perineal hernia later in life.
The rare cases in older age group should be resected without the bony resections if possible.
Two approaches towards fetal intervention are possible for fetuses with hydrops: minimally invasive surgery and open fetal surgery. Minimally invasive fetal surgery involves inserting a needle through the mother’s abdomen and uterine wall and into the blood vessels that feed the tumor. Radiofrequency waves are used to destroy the blood vessels and, without blood flow, the tumor does not grow and heart failure (hydrops) is reversed. However, damage caused by the probe itself may be difficult to control. Another method of cutting off blood flow to the tumor is injection of drugs (for example, alcohol) that cause blood to clot. None of these methods has so far proven effective in all cases.
Open fetal surgery is an alternative option. In this case, the mother’s uterus is opened under general anesthesia and the fetus’s SCT is surgically removed.
What is Sacrococcygeal Teratoma (SCT)?,
Description of Sacrococcygeal Teratoma (SCT) and it's affects on the fetus,
Open Fetal Surgery for Sacrococcygeal Teratoma,
Patient's Sacrococcygeal Teratoma Story,
How a newborn with sacrococcygeal teratoma should be worked up? ,
Sacrococcygeal Teratoma SCT - treatment options,
What is sacrococcygeal teratoma? What are the chances to survive it?,
Sacrococcygeal Teratoma (SCT) - diagnosis via sonogram,
Sacrococcygeal Teratoma (SCT) - What choices do you have?,
Sacrococcygeal Teratoma - longterm outcome,
Why do sacrococcygeal teratomas occur more often in females than males?,
acrococcygeal Teratoma (SCT) - range of outcomes,
Sacrococcygeal Teratoma (Malignant) Operation,
one month old baby with sacrococcygeal teratoma (SCT) ,
Germ cell tumors - causes, symptoms, pathology, diagnosis, treatment,
The tumour is composed of the all three germ cells (i.e. ectoderm, mesoderm and endoderm).
It is the most common congenital germ cell tumor diagnosed in infants and children younger than 4 years.
Incidence: 1 in 35,000-40,000 live births.
F: M 3:1-4:1 ratio
It is more common in girls
Classification is given be Altman and is as follows
TYPE 1 - Entirely exophytic.
TYPE 2 - Nearly entirely exophytic.
TYPE 3 - Mostly to the inside.
TYPE 4 - Entirely inside. Also called retrorectal teratoma or presacral teratoma
The Currarino triad , due to an autosomal dominant mutation in the MNX1 gene, consists of a presacral mass (usually a mature teratoma or anterior meningocele), anorectal malformation and sacral dysgenesis.
Symptoms can be a presacral mass, constipation, urinary difficulties, bowel obstruction, hydronephrosis and so on
A solid or cystic mass on prenatal ultrasound and growing internally or externally.
Other tumors can occur in the sacrococcygeal and/or presacral regions and hence must be ruled out to obtain a differential diagnosis. These include extraspinal ependymoma, ependymoblastoma, neuroblastoma and rhabdomyosarcoma.
If baby’s condition is stable with no high output cardiac failure (fetal hydrops), pregnancy will be followed with regular ultrasound monitoring. If the SCT is small, a vaginal delivery at term may be planned.
If the SCT is large or if there is an excess of amniotic fluid (polyhydramnios), an early cesarean section is planned to avoid tumor rupture as well as the risks of preterm labor and premature delivery.
If fetal hydrops develops, it may be a candidate for fetal surgery.
In cases with extreme fetal hydrops, the mother may be at risk for maternal mirror syndrome, in which the mom’s condition parallels & mimics that of the sick fetus. When fetal hydrops is present, the mother may "mirror" the sick fetus, becoming ill with signs of preeclampsia. Because of a hyperdynamic cardiovascular state, the mother develops symptoms that are similar to pre-eclampsia and may include vomiting, hypertension, peripheral edema (swelling of the hands and feet), proteinuria (protein in the urine), and pulmonary edema (fluid in the lungs). Despite resection of the fetal SCT, maternal mirror syndrome may still occur.
Preeclampsia, also called toxemia, is a condition characterized by pregnancy-induced high blood pressure, protein in the urine, and swelling due to fluid retention.
Complete surgical removal after birth through a perineal or abdominal approach. The preferred approach to a small SCT is through the perineum; a large SCT may require an additional approach through the abdomen.
The procedure includes resection of the involved parts of coccyx and sacrum and reattachments of the muscles that are attached to these bony segments in the usual cases. If not, there is an increased risk of perineal hernia later in life.
The rare cases in older age group should be resected without the bony resections if possible.
Two approaches towards fetal intervention are possible for fetuses with hydrops: minimally invasive surgery and open fetal surgery. Minimally invasive fetal surgery involves inserting a needle through the mother’s abdomen and uterine wall and into the blood vessels that feed the tumor. Radiofrequency waves are used to destroy the blood vessels and, without blood flow, the tumor does not grow and heart failure (hydrops) is reversed. However, damage caused by the probe itself may be difficult to control. Another method of cutting off blood flow to the tumor is injection of drugs (for example, alcohol) that cause blood to clot. None of these methods has so far proven effective in all cases.
Open fetal surgery is an alternative option. In this case, the mother’s uterus is opened under general anesthesia and the fetus’s SCT is surgically removed.
What is Sacrococcygeal Teratoma (SCT)?,
Description of Sacrococcygeal Teratoma (SCT) and it's affects on the fetus,
Open Fetal Surgery for Sacrococcygeal Teratoma,
Patient's Sacrococcygeal Teratoma Story,
How a newborn with sacrococcygeal teratoma should be worked up? ,
Sacrococcygeal Teratoma SCT - treatment options,
What is sacrococcygeal teratoma? What are the chances to survive it?,
Sacrococcygeal Teratoma (SCT) - diagnosis via sonogram,
Sacrococcygeal Teratoma (SCT) - What choices do you have?,
Sacrococcygeal Teratoma - longterm outcome,
Why do sacrococcygeal teratomas occur more often in females than males?,
acrococcygeal Teratoma (SCT) - range of outcomes,
Sacrococcygeal Teratoma (Malignant) Operation,
one month old baby with sacrococcygeal teratoma (SCT) ,
Germ cell tumors - causes, symptoms, pathology, diagnosis, treatment,
4 سال پیش
در تاریخ 1399/03/04 منتشر شده
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