Sacrococcygeal Teratoma in Sweden
Title: "Sacrococcygeal Teratoma in Sweden: A 10 Year National
Retrospective Study (27 J. of Ped. Surg. 1447-1450 Nov. 1992)"
A group of Swedish pediatric surgeons reviewed children's records evidencing
presence of an SCT over a 10 year period (1980-1989). The records were compiled
from 4 university hospitals where all children in Sweden with SCTs would have
been treated during the years in question.
The study determines that there were 32 cases of SCT reported in the medical
records of the 4 university hospitals. This number (and this study) does not
include fetuses with SCT who were aborted or who died in utero or were stillborn.
The study notes that records are not kept for such babies.
The sex ratio for the 32 patients showed girls were afflicted nearly twice as
much as boys (1.9:1). A diagnosis of SCT was made at delivery in the case of
15 children, prenatally in 8, and postnatally (between 2 months and 3 years of
age) in 9 children.
7 of the 8 children diagnosed prenatally were delivered by c-section
after 32 weeks of gestation. In 4 of the 8 childen with prenatally
diagnosed SCTs, massive
hemorrhage into the tumor was observed during the operation to resect the tumor.
One of these four babies died 10 days following surgery as a result of pneumonia.
Of the 15 babies diagnosed at delivery, 14 of the tumors were benign,
1 was immature and none was malignant. Of the 9 babies diagnosed
postnatally, 4 babies had benign
tumors and 5 had malignant tumors. These 9 babies had tumors that were either
wholly internal (Type IV) or largely internal with a small external mass (Type
AFP levels, used as a marker of malignancy, were checked postnatally
in 20 children. In 9 of the 20 cases, AFP levels were elevated
and a malignant tumor was found
in all 9 cases.
Within 29 months after birth, 11 of the 32 patients had developed malignant
tumors. 10 of 11 of these children were treated with multi-agent chemotherapy
10 survived. 1 of the 11 was treated with single-agent chemotherapy and died.