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2003-10-28-10 Sacrococcygeal teratoma, Type III © Sosa www.thefetus.net/


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
 

The end of the spine


 Close up of end of spine


The teratoma compresses the anogenital region
 

Thoraco-abdominal disproportion

 

Lateral view of the fetus (sliced)


Right fetal hemibody


End of the spine

The internal component of the teratoma is 3 times longer than external component

Compressed diaphragm by the subphrenic teratoma  

 

External portion of the teratoma


Renal pelvis dilatation

The right kidney

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