A Clinical Analysis of the Diagnosis and Treatment of Fetal Sacrococcygeal Teratomas

Xiu-Qiong Zheng; Jian-Ying Yan; Rong-Li Xu; Xue-Chun Wang; Xian Chen; Ke-Hua Huang

doi:10.2147/CMAR.S287682

A Clinical Analysis of the Diagnosis and Treatment of Fetal Sacrococcygeal Teratomas

Cancer Manag Res. 2020 Dec 23:12:13185-13193. doi: 10.2147/CMAR.S287682. eCollection 2020.

Authors

Xiu-Qiong Zheng^#¹, Jian-Ying Yan¹, Rong-Li Xu^#¹, Xue-Chun Wang¹, Xian Chen², Ke-Hua Huang¹

Affiliations

¹ Department of Obstetrics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, People's Republic of China.
² Department of Obstetrics, Fujian Obstetrics and Gynecology Hospital, Fuzhou 350000, People's Republic of China.

^# Contributed equally.

Abstract

Objective: The present study aims to discuss the clinical features, treatment, and prognosis of fetal sacrococcygeal teratomas (SCTs) to improve the standard of diagnosis and treatment.

Methods: The clinical data of 15 pregnant females with fetal SCT, admitted to Fujian Maternity and Child Health Hospital from January 2013 to January 2020, were retrospectively analyzed with respect to clinical characteristics, imaging features, complications, treatment options, and pregnancy outcomes.

Results: The 15 cases of fetal SCT were all detected by color ultrasonography. There were two cases of cystic tumors and 13 cases of solid cystic tumors. In terms of tumor blood supply, there was one case without blood flow signal, eight cases with little blood flow signal, and six cases with abundant blood flow. At the time of delivery, there were two cases with a tumor diameter less than 5 cm, five cases with a diameter of 5-10 cm, and eight cases with a diameter of more than 10 cm. In terms of tumor shape and location, there were two cases of type I, ten cases of type II, and three cases of type III. There were six cases with an increased fetal heart to chest ratio, four cases of fetal edema, three cases of placental edema, four cases of excessive amniotic fluid, one case of insufficient amniotic fluid, three cases of fetal distress, one case of stillbirth, two cases of gestational diabetes mellitus, two cases of mirror syndrome, and two cases of postpartum hemorrhage. According to the pathological diagnosis, there were seven cases of mature teratoma, seven cases of immature teratoma, and one case of mixed germ cell tumor. There were six cases of induced delivery, nine cases of cesarean section, one case of premature birth, and two cases of mild neonatal asphyxia.

Conclusion: Fetal SCT was generally diagnosed by prenatal ultrasonography. The tumor blood supply, growth rate, size, nature of the tumor, clinical type, pathology, and maternal-fetal complications are all closely correlated with the prognosis. The timing and manner of the termination of pregnancy should be determined on the basis of the pregnant female, the fetus, and the tumor.

Keywords: fetus; prognosis; sacrococcygeal; teratoma; therapy.

Grants and funding

This study was funded by:1. Guide Fund for the Development of Local Science and Technology from the Central Government (2020L3019)2. National Health and Family Planning Commission Science Foundation (2019-WJ-04)3. Fujian Science and Technology Project (2018Y0005)4. Key Clinical Specialty Discipline Construction of Fujian, P.R.C ([2015] no. 593)The funding body had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.