Sacrococcygeal teratoma, Type III

Miguel Octavio Sosa Palaviccini, MD, Daniel Chirinos, MD

Hospital Antonio M. Pineda, Barquisimeto, Venezuela

This is the first pregnancy of a 29-year-old patient. Her 8 previous ultrasonograms elsewhere had been reported as normal aside from the last exam that suspected bright bowel. This examination was performed at 39 weeks. The large subdiaphragmatic mass extends caudally to the sacrococcygeal zone. It is very heterogeneous with echogenic zones alternating with fluid-filled zones. The vertebral bodies were normal. There was bilateral hydronephrosis.

Skin edema at the level of the skull:

Sagittal view: left side of tumor (extracorporeal zone of teratoma), right side: intra abdominal extention )

Vertebral body at 5 o"clock . Transversal section of upper abdomen, non-visible stomach

Left side: extension in the abdomen, right side: size of thorax

Renal compression by the tumor

Pyelectasis in longitudinal section

Renal pelvis with dilatation

Transverse sections of both kidneys

End of spine

Close up of end of spine

Multiples cavities inside the tumor

The teratoma does not permit to identify genitalia or anus

Cardiothoracic disproportion due to oligoamnios, pulmonary hypoplasia

The newborn was delivered by cesarean section and weighted 4200 g and 56 cm of long. She presented with facial skin with edema. The baby went into respiratory distress and died 30 minutes after birth. The parents gave the newborn for pathological study. The autopsy confirmed a type III sacrococcygeal teratoma.

Facial edema