Teratoma sacrococcígeo fetal. Diagnóstico y manejo prenatal

Authors

Keywords:

Teratoma, Sacrococcígeo, Diagnóstico Prenatal, Terapia Fetal, Ablación Láser, Ablación por Radiofrecuencia, Sacrococcygeal, Prenatal Diagnosis, Fetal Therapy, Laser Ablation, Radiofrequency Ablation

Abstract

Sacrococcygeal teratomas are frequently diagnosed prenatally. Although histologically they are usually benign, it is important to carry out adequate follow-up to detect if there is any type of complication that may require prenatal treatment or to end the pregnancy. In some cases in these fetuses we can observe urinary and fecal complications, severe heart failure, hydrops and even intrauterine death. The clinical case of a primigravida patient diagnosed at week 14 of gestation with a fetal malformation compatible with sacrococcygeal teratoma is presented. During prenatal follow-up, the mass grows rapidly, showing ultrasound signs of kidney and heart failure three weeks after diagnosis. Given the unfavorable prognosis, the patient decided legal induced abortion. In this work we will review the management of this type of patient, the diagnostic and therapeutic procedures indicated to avoid prenatal complications and the current recommendations to achieve the best maternal-fetal results.

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References

Gabra HO, Jesudason EC, McDowell HP, Pizer BL, Losty PD. Sacrococcygeal teratoma--a 25-year experience in a UK regional center. J Pediatr Surg. 2006; 41(9):1513-1516. doi: 10.1016/j.jpedsurg.2006.05.019.

Coleman BG, Adzick NS, Crombleholme TM, Johnson MP, Howell L, Horii SC, et al. Fetal therapy: state of the art. J Ultrasound Med. 2002; 21(11):1257-1288. doi: 10.7863/jum.2002.21.11.1257.

Tuladhar R, Patole SK, Whitehall JS. Sacrococcygeal teratoma in the perinatal period. Postgrad Med J. 2000; 76(902):754-759. doi: 10.1136/pmj.76.902.754.

Wee WW, Tagore S, Tan JV, Yeo GS. Foetal sacrococcygeal teratoma: extremes in clinical presentation. Singapore Med J. 2011 [consultado 4 de enero de 2022]; 52(6):e118-123. Disponible en: http://smj.sma.org.sg/5206/5206cr4.pdf.

Hernández-Higareda S, Pérez-Pérez OA, Balderas-Peña LM, Martínez-Silva MG, González-Amador Y, de Alba-García JG. [Sacrococcygeal teratoma: report of a case and review of the literature]. Ginecol Obstet Mex. 2013[consultado 4 de enero de 2022]; 81(11):668-673. Spanish. Disponible en: https://www.medigraphic.com/pdfs/ginobsmex/gom-2013/gom1311g.pdf

Krekora M, Zych-Krekora K, Blitek M, Kęsiak M, Piaseczna-Piotrowska A, Łukaszek S, et al. Difficulties in prenatal diagnosis of tumour in the fetal sacrococcygeal area. Ultrasound. 2016; 24(2):119-124. doi: 10.1177/1742271X16642637.

Molina Vital R, de Santiago Valenzuela JM, de Lira Barraza RC. Sacrococcygeal teratoma: case report. Medwave. 2015; 15(4):e6137. doi: 10.5867/medwave.2015.04.6137.

Gucciardo L, Uyttebroek A, De Wever I, Renard M, Claus F, Devlieger R et al. Prenatal assessment and management of sacrococcygeal teratoma. Prenat Diagn. 2011; 31(7):678-688. doi: 10.1002/pd.2781.

Grigore M, Iliev G. Diagnosis of sacrococcygeal teratoma using two and three-dimensional ultrasonography: two cases reported and a literature review. Med Ultrason. 2014; 16(3):274-277. doi: 10.11152/mu.2013.2066.163.mg1gi2.

Özsürmeli M, Büyükkurt S, Sucu M, Arslan E, Mısırlıoğlu S, Akçabay Ç, et al. Evaluation of prenatally diagnosed fetal sacrococcygeal teratomas: A case series of seventeen pregnancies from South-central Turkey. Turk J Obstet Gynecol. 2020; 17(3):170-174. doi: 10.4274/tjod.galenos.2020.68812.

Chen CP, Sheu JC, Huan JK, Lin YH, Tzen CY, Wang W. Second-trimester magnetic resonante Imaging of fetal sacrococcygeal teratoma with intrapelvic extensión in a co-twin. Prenat Diagn. 2004; 24 (12):1015-1017. doi: 10.1002/pd.946.

Fumino S, Tajiri T, Usui N, Tamura M, Sago H, Ono S, et al. Japanese clinical practice guidelines for sacrococcygeal teratoma, 2017. Pediatr Int. 2019 Jul; 61(7):672-678. doi: 10.1111/ped.13844.

Baumgarten HD, Gebb JS, Khalek N, Moldenhauer JS, Johnson MP, Peranteau WH, et al. Preemptive delivery and immediate resection for fetuses with high-risk sacrococcygeal teratomas. Fetal Diagn Ther. 2019; 45(3):137-44. doi: 10.1159/000487542.

Isserman RS, Nelson O, Tran KM, Cai L, Polansky M, Rosenbloom JM, et al. Risk factors for perioperative mortality and transfusion in sacrococcygeal teratoma resections. Paediatr Anaesth. 2017; 27(7):726-732. doi: 10.1111/pan.13143.

Zheng XQ, Yan JY, Xu RL, Wang XC, Chen X, Huang KH. A Clinical Analysis of the diagnosis and treatment of fetal sacrococcygeal teratomas. Cancer Manag Res. 2020; 12:13185-13193. doi: 10.2147/CMAR.S287682.

Litwińska M, Litwińska E, Janiak K, Piaseczna-Piotrowska A, Szaflik K. Percutaneous intratumor laser ablation for fetal sacrococcygeal teratoma. Fetal Diagn Ther. 2020; 47(2):138-44. doi: 10.1159/000500775

Published

2022-08-31

How to Cite

Romero Matas, M., Fernández Ruiz, M., Frías Sánchez, Z., & Pantoja Garrido, M. (2022). Teratoma sacrococcígeo fetal. Diagnóstico y manejo prenatal. Revista De Obstetricia Y Ginecología De Venezuela, 82(2), 264–269. Retrieved from https://saber.ucv.ve/ojs/index.php/rev_ogv/article/view/24377

Issue

Section

Caso Clínico

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