What is a Sacrococcygeal Teratoma?
A sacrococcygeal teratoma (SCT) is a tumor that grows at the base of the baby's spine near the coccyx (tailbone). Sacrococcygeal teratomas may grow to become very large and may cause problems for your baby before birth. This is the most common tumor found in newborns, and is more common in boys than in girls. Most are not cancerous but may become so if not removed. SCTs are removed surgically after the baby is born and most babies recover completely with no further problems. In rare situations, the tumor needs to be addressed before birth because of its effect on the baby's heart or other organs.
How is a sacrococcygeal teratoma diagnosed?
If your baby has an SCT, a mass may be detected on a prenatal ultrasound. The mass may look like a fluid-filled sac called a "cyst," or appear to be solid, or may be both cystic and solid. There are other symptoms that indicate that your baby may have an SCT. These include raised levels of alpha-fetoprotein (AFP) in your own blood.
How does a sacrococcygeal teratoma affect my baby's health?
SCTs may grow outside the baby's abdomen, inside the abdomen, or both. A mass growing internally may put pressure on the baby's organs such as the bladder, causing more health problems. Before birth your OB doctor will measure the tumor to follow growth and determine how it affects the baby's other organs. A solid tumor can cause more of a problem than a cystic one, as solid tumors contain more blood vessels. This increase in blood flow may stress the baby's heart and result in heart failure. This causes extra fluid to develop in the baby and is called hydrops. This a life-threatening condition.
Babies with large SCTs that are mostly cystic rarely develop hydrops. It is rare for SCTs to be cancerous. Most newborns with SCT survive and recover well. Babies that have solid SCT's that grow quite large are at highest risk for hydrops. Babies with SCT are at risk for bleeding from the SCT and into the SCT around the time of delivery and shortly thereafter.
How will a sacrococcygeal teratoma affect my baby's birth?
Your doctor will recommend delivery of your baby by a Cesarean-section if the tumor is too large, or at risk for rupture. All babies with SCT should be delivered at a hospital called a "tertiary center," meaning that it has the staff and equipment ready to support a baby needing surgery or intensive care. The neonatologist will provide special care for your baby in the intensive care nursery until the baby is stable enough for surgery.
What will happen after birth?
While most babies with sacrococcygeal tumors do well with surgery after birth, several factors are involved in the health of your baby after delivery:
Small external tumors: The pediatric surgeon removes the tumor with the coccyx bone (tailbone) after birth. These babies can be expected to live normal lives.
Large external tumors: Surgery is more complex but the tumor and a portion of the tailbone are removed.
Large internal tumors and combined internal and external (dumbbell) tumors: Surgery may require both an abdominal and a pelvic procedure but most babies recover well with no long-term problems.
Very large tumors: Fetuses with very large tumors, in some cases as large as the fetus itself, pose a difficult problem both before and after birth.
© 2013 Monroe Carell Jr. Children's Hospital at Vanderbilt