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Sacrococcygealteratoma in Newborns: Management and Outcome

Author: Hasan K.Gatea*, Moaied A. Hassan**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 174-179
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Sacrococcygeal teratoma is the most common tumor in the newborn.. Approximately 90% of sacrococcygeal teratomas excised during the neonatal period are benign. The risk of malignancy increases in lesions removed after 6 months of age. OBJECTIVE::To discuss the management of newborns with sacrococcygeal teratomas and the importance of early surgical intervention in avoiding the risk of malignant transformation.PATIENTS AND METHODS: 11 neonates with sacrococcygeal teratomas were managed during the period from April 2008 through April 2013. In all cases, age, sex, mode of delivery, details of surgery, extent of resection, macroscopic tumor appearance, tumor histology, Altman classification and postoperative morbidity and mortality were all documented and analyzed. A two years follow up plan was designed to assess any complication and tumor recurrence.RESULTS: Classical sacrococcygeal approach was performed in all of the patients operated upon and complete excision of the tumor along with the coccyx was possible in all cases. According to the Altman classification 8 (72.7%) of the tumors were of type I. Macroscopically, 7(63.6%) tumors were mixed,. Histopathological examination of the excised tumors revealed the diagnosis of benign mature teratoma in all cases. All of the newborns survived with the exception of one patient with a giant sacrococcygeal mass who died because of heart failure . No tumor recurrence was documented in all of the patients operated on.CONCLUSION:Early detection including antenatal diagnosis is essential to define fetuses with poor prognostic signs and deciding the appropriate mode of delivery, and in some centers even fetal intervention. Early excision of these tumors during the neonatal period is essential to avoid the risk of malignant transformation.

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