Pediatrics and Neonatology

Biography

Viveka Singh, is an accredited Pediatrician and Neonatologist whose areas of expertise include newborn intensive care and pediatrics. Her areas of interest include neonatal and pediatric intensive care, neonatal hemodynamics, point of care neonatal ultrasound and functional echocardiography, pediatric allergy and asthma. Expert guidance provided by her mentor, Dr Amit Nigade, along with the team of specialist doctors, had immensely helped her in formulating the report. It adds another case of this rare pathology that highlights its clinical presentation, excellent prognosis provided by prompt surgical treatment and successful neonatal outcomes.

 

 

Abstract

 

A rare case of sacrococcygeal teratoma in a neonate

Viveka Singh¹, Sandip Bandewar¹, Amit Nigade¹, Pranav Jadhav²

¹Department of Neonatology, ²Department of Pediatric Surgery, Cloudnine Hospital [Kalyani Nagar Branch], Pune, India.

ABSTRACT

Sacrococcygeal teratomas [SCT] are uncommon germ cell neoplasms which develop in fetal life and present as a large mass extending from sacrum in neonatal period. Diagnosis is established by prenatal ultrasound [USG]. A close antenatal observation is necessary to look for fatal complications. Non vascular tumors and those less than 10 cm in diameter may be delivered vaginally. Perinatal morbidity and mortality are associated with this defect. Associated anorectal and genital malformations should be ruled out. Differentiation from myelocystocele or myelomeningocele is crucial. It is essential to perform USG and computed tomography [CT] or magnetic resonance imaging [MRI] postnatally to identify the extent of tumor. Management requires an interdisciplinary liaison between obstetrician, neonatologist and surgeon. Early complete surgical resection of tumor with coccygectomy is the treatment of choice to prevent recurrence. Excised mass is classified as mature, immature and malignant tumor based on histopathology.  Mature and immature teratomas have good prognosis while malignant teratoma have a tendency to recur and metastasize. Close follow up with rectal examination, alpha feto-protein level and diagnostic imaging are advisable. We report a rare case of mature SCT presenting with a large sacrococcygeal swelling at birth. This case highlights its clinical presentation and excellent prognosis provided by prompt surgical treatment.  This case would be one of the few cases reported from India.

BIOGRAPHY

Viveka Singh, is an accredited Pediatrician and Neonatologist whose areas of expertise include newborn intensive care and pediatrics. Her areas of interest include neonatal and pediatric intensive care, neonatal hemodynamics, point of care neonatal ultrasound and functional echocardiography, pediatric allergy and asthma. Expert guidance provided by her mentor, Dr Amit Nigade, along with the team of specialist doctors, had immensely helped her in formulating the report. It adds another case of this rare pathology that highlights its clinical presentation, excellent prognosis provided by prompt surgical treatment and successful neonatal outcomes.