• A rare observation of resection of giant sacrococcygeal teratoma complicated by massive bleeding in a newborn child
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A rare observation of resection of giant sacrococcygeal teratoma complicated by massive bleeding in a newborn child

Paediatric Surgery (Ukraine). 2025. 1(86): 137-140. doi: 10.15574/PS.2025.1(86).137140
Soroka V. P.
Center for neonatal surgery for malformations and their rehabilitation of SI «Ukrainian center of мaternity and childhood of the NAMS of Ukraine», Kyiv

For citation: Soroka VP. (2025). A rare observation of resection of giant sacrococcygeal teratoma complicated by massive bleeding in a newborn child. Paediatric Surgery (Ukraine). 1(86): 137-140. doi: 10.15574/PS.2025.1(86).137140.
Article received: Nov 18, 2024. Accepted for publication: Mar 18, 2025.

Aim – is to analyze and describe the experience of surgical treatment of giant sacrococcygeal teratoma (SCT) complicated by massive bleeding in a newborn child.
Clinical case. A rare clinical observation of resection of giant sacrococcygeal teratoma complicated by massive bleeding in a newborn child is presented.
Conclusions. In the presence of negative prognostic factors associated with the risk of hemodynamic and hemorrhagic complications, it is advisable to consider the possibility of surgical treatment in the early neonatal period to prevent fatal consequences. A 2-stage surgical treatment tactic for life-threatening massive bleeding is described, which allowed to eliminate a formidable complication, stabilize the child's condition, ensure effective preoperative preparation and perform subsequent radical resection of the tumor with a good postoperative result.
The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting studies.
No conflict of interests was declared by the authors.
Keywords: giant sacrococcygeal teratoma, complications of teratoma, massive bleeding, newborn child.

REFERENCES

1. Angel CA, Murillo C, Mayhew J. (1998). Experience with vascular control before excision of giant, highly vascular sacrococcygeal teratomas in neonates. J Pediatr Surg. 33: 1840-1842. https://doi.org/10.1016/S0022-3468(98)90302-5; PMid:9869068

2. Bax NM, van der Zee DC. (1998). Laparoscopic clipping of the median sacral artery in huge sacrococcygeal teratomas. Surg Endosc. 12: 882-883. https://doi.org/10.1007/s004649900735; PMid:9602012

3. Bond SJ, Harrison MR, Schmidt KG, Silverman NH, Flake AW, Slomick RN et al. (1990). Death due to high output cardiac failure in fetal sacrococcygeal teratoma. J Pediatr Surg. 25: 1287-1291. https://doi.org/10.1016/0022-3468(90)90535-H; PMid:2286911

4. Chirdan LB, Uba AF, Pam SD, Edino ST, Mandong BM, Chirdan OO. (2009, Apr-Jun). Sacrococcygeal teratoma: clinical characteristics and long-term outcome in Nigerian children. Ann Afr Med. 8(2): 105-109. https://doi.org/10.4103/1596-3519.56238; PMid:19805941

5. Cowles RA, Stolar CJ, Kandel JJ, Weintraub JL, Susman J, Spigland NA. (2006, Jun). Preoperative angiography with embolization and radiofrequency ablation as novel adjuncts to safe surgical resection of a large, vascular sacrococcygeal teratoma. Pediatr Surg Int. 22(6): 554-556. https://doi.org/10.1007/s00383-006-1650-7; PMid:16479404

6. Kaneyama K, Yamataka A, Kobayashi H, Lane GJ, Itoh S et al. (2004, Dec). Giant, highly vascular sacrococcygeal teratoma: report of its excision using the ligasure vessel sealing system. J Pediatr Surg. 39(12): 1791-1793. https://doi.org/10.1016/j.jpedsurg.2004.08.031; PMid:15616931

7. Kremer ME, Wellens LM, Derikx JP, van Baren R, Heij HA, Wijnen MH et al. (2016, Nov). Hemorrhage is the most common cause of neonatal mortality in patients with sacrococcygeal teratoma. J Pediatr Surg. 51(11): 1826-1829. Epub 2016 Jul 27. https://doi.org/10.1016/j.jpedsurg.2016.07.005; PMid:27502009

8. Lund DP, Soriano SG, Fauza D et al. (1995). Resection of a massive sacrococcygeal teratoma using hypothermic hypoperfusion: a novel use of extracorporeal membrane oxygenation. J Pediatr Surg. 30: 1557-1559. https://doi.org/10.1016/0022-3468(95)90156-6; PMid:8583324

9. Murphy JJ, Blair GK, Fraser GC. (1992, Oct). Coagulopathy associated with large sacrococcygeal teratomas. J Pediatr Surg. 27(10): 1308-1310. https://doi.org/10.1016/0022-3468(92)90282-C; PMid:1403511

10. Osei H, Munoz-Abraham AS, Bates KS, Kim JS, Saxena S et al. (2019, Feb). Laparoscopic Division of Median Sacral Artery and Dissection of Types III and IV Sacrococcygeal Teratomas to Decrease Intraoperative Hemorrhagic Complications: Case Series and Review of the Literature. J Laparoendosc Adv Surg Tech A. 29(2): 272-277. https://doi.org/10.1089/lap.2018.0189; PMid:30351221

11. Pauniaho SL, Heikinheimo O, Vettenranta K et al. (2013). High prevalence of sacrococcygeal teratoma in Finland – a nationwide population based study. Acta Paediatr. 102(6): e251-256. https://doi.org/10.1111/apa.12211; PMid:23432104

12. Swamy R, Embleton N, Hale J. (2008). Sacrococcygeal teratoma over two decades: birth prevalence, prenatal diagnosis and clinical outcomes. Prenat Diagn. 28(11): 1048-1051. https://doi.org/10.1002/pd.2122; PMid:18973151

13. Shue E, Bolouri M, Jelin EB, Vu L, Bratton B, Cedars E et al. (2013). Tumor metrics and morphology predict poor prognosis in prenatally diagnosed sacrococcygeal teratoma: a 25-year experience at a single institution. J Pediatr Surg. 48: 1225-1231. https://doi.org/10.1016/j.jpedsurg.2013.03.016; PMid:23845611

14. Teitelbaum D, Teich S, Cassidy S, Karp M, Cooney D, Besner G (1994) Highly vascularized sacrococcygeal teratoma: description of this atypical variant and its operative management. J Pediatr Surg 29: 98-101. https://doi.org/10.1016/0022-3468(94)90534-7; PMid:8120774

15. Van Heurn LJ, Coumans ABC, Derikx JPM, Bekker MN, Bilardo KM, Duin LK et al. (2021, Oct). Factors associated with poor outcome in fetuses prenatally diagnosed with sacrococcygeal teratoma. Prenat Diagn. 41(11): 1430-1438. Epub 2021 Aug 5. https://doi.org/10.1002/pd.6026; PMid:34327722 PMCid:PMC9292788

16. Zvizdic Z et al. (2023, Mar). A Long-Term Outcome of the Patients with Sacrococcygeal Teratoma: A Bosnian Cohort. Turk Arch Pediatr. 58(2): 168-173. https://doi.org/10.5152/TurkArchPediatr.2023.22268; PMid:36856354 PMCid:PMC10081131