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CC BY 4.0 · European J Pediatr Surg Rep. 2024; 12(01): e11-e15
DOI: 10.1055/a-2206-4825
Case Report

Neonatal Sacrococcygeal Fetiform Teratoma Containing Bowel: A Case Report

Ashley Toms
1   Department of Paediatric surgery, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
,
Tarlia Rasa Govender
1   Department of Paediatric surgery, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
,
Giulia Brisighelli 
1   Department of Paediatric surgery, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
,
Derek Harrison
1   Department of Paediatric surgery, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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Abstract

A fetiform sacrococcygeal teratoma (homunculus) is a highly differentiated subgroup of mature cystic teratoma that resembles a malformed fetus. These tumors originate at the base of the coccyx and may vary in their intrapelvic and extrapelvic extent and location. It is important to differentiate this anomaly from fetus-in-fetu which has a higher degree of structural organization. A 5-day-old neonate presented with a type II sacrococcygeal fetiform teratoma. The mass contained both cystic and solid components. Upon surgical excision and coccygectomy, fully formed bowel was found inside the mass, as well as bones and other well-defined structures. The tumor was confirmed to be fully excised and no malignant or immature features were found on histopathological examination. The patient was last seen growing well with an alpha-fetoprotein of 3.5 μg/L, 14 months after resection.

Keywords

sacrococcygeal teratoma - fetiform teratoma - fetus-in-fetu - germ cell tumor

Ethical Approval

This case report received ethical clearance from the human research ethics committee at the University Witwatersrand in Johannesburg.




Publication History

Received: 20 May 2023

Accepted: 21 October 2023

Accepted Manuscript online:
08 November 2023

Article published online:
22 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Savitri QM, Prihartono S, Harahap A. Giant sacrococcygeal teratoma in newborn: a rare case. J Pediatr Surg Case Rep 2019; 47
    CrossrefPubMedSearch in Google Scholar
  • 2 Nikumbh RD, Nikumbh DB, Singhavi S. Histological and embryonic overview of sacrococcygeal teratoma: a six year retrospective study. Int J Anat Res 2016; 4 (01) 2108-2113
    CrossrefPubMedSearch in Google Scholar
  • 3 Pace S, Sacks MA, Goodman LF, Tagge EP, Radulescu A. Antenatal diagnosis of retroperitoneal cystic mass: fetiform teratoma or fetus in fetu? A case report. Am J Case Rep 2021; 22: e929247
    CrossrefPubMedSearch in Google Scholar
  • 4 Prescher LM, Butler WJ, Vachon TA. et al. Fetus in fetu: review of the literature over the past 15 years. J Pediatr Surg Case Rep 2015; 3 (12) 554-562
    CrossrefPubMedSearch in Google Scholar
  • 5 Weiss JR, Burgess JR, Kaplan KJ. Fetiform teratoma (homunculus). Arch Pathol Lab Med 2006; 130 (10) 1552-1556
    CrossrefPubMedSearch in Google Scholar
  • 6 Roman AS, Monteagudo A, Timor-Tritsch I, Rebarber A. First-trimester diagnosis of sacrococcygeal teratoma: the role of three-dimensional ultrasound. Ultrasound Obstet Gynecol 2004; 23 (06) 612-614
    CrossrefPubMedSearch in Google Scholar
  • 7 Hambraeus M, Hagander L, Stenström P, Arnbjörnsson E, Börjesson A. Long-term outcome of sacrococcygeal teratoma: a controlled cohort study of urinary tract and bowel dysfunction and predictors of poor outcome. J Pediatr 2018; 198: 131-136.e2
    CrossrefPubMedSearch in Google Scholar
  • 8 Szyllo K, Lesnik N. Sacrococcygeal teratoma - case report and review of the literature. Am J Case Rep 2013; 14: 1-5
    CrossrefPubMedSearch in Google Scholar
  • 9 Harms D, Zahn S, Göbel U, Schneider DT. Pathology and molecular biology of teratomas in childhood and adolescence. Klin Padiatr 2006; Nov-Dec; 218 (06) 296-302
    Thieme ConnectPubMedSearch in Google Scholar
  • 10 Gonzalez-Crussi F, Winkler RF, Mirkin DL. Sacrococcygeal teratomas in infants and children: relationship of histology and prognosis in 40 cases. Arch Pathol Lab Med 1978; 102 (08) 420-425
    PubMedSearch in Google Scholar
  • 11 Sood N, Kamboj M, Chaabra M. Sacrococcygeal fetiform teratoma Altman type 1: a rare case report in a 11 year old girl. Indian J Surg 2013; 75 (Suppl. 01) 359-361
    CrossrefPubMedSearch in Google Scholar
  • 12 Kuno N, Kadomatsu K, Nakamura M, Miwa-Fukuchi T, Hirabayashi N, Ishizuka T. Mature ovarian cystic teratoma with a highly differentiated homunculus: a case report. Birth Defects Res A Clin Mol Teratol 2004; 70 (01) 40-46
    CrossrefPubMedSearch in Google Scholar
  • 13 Derikx JP, De Backer A, van de Schoot L. et al. Long-term functional sequelae of sacrococcygeal teratoma: a national study in The Netherlands. J Pediatr Surg 2007; 42 (06) 1122-1126
    CrossrefPubMedSearch in Google Scholar