Teratomas are made up of various parenchymal cell types from > 1 germ layer, usually all 3
Tumors may contain hair, teeth, cartilage, & fat, among other tissues
SCT arises from pluripotential cells at caudal tip of notochord (coccyx)
Can grow both internally & externally (with latter being more common)
Both benign & malignant varieties exist
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
CT Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Seilern Und Aspang J et al: Sacrococcygeal teratoma with intraspinal extension: a case series and review of literature. J Pediatr Surg. 55(10):2022-5, 2020
Baumgarten HD et al: Preemptive delivery and immediate resection for fetuses with high-risk sacrococcygeal teratomas. Fetal Diagn Ther. 45(3):137-44, 2019
Gebb JS et al: High tumor volume to fetal weight ratio is associated with worse fetal outcomes and increased maternal risk in fetuses with sacrococcygeal teratoma. Fetal Diagn Ther. 45(2):94-101, 2019
Ladenhauf HN et al: Sacrococcygeal teratoma presenting with vaginal discharge and polyp in an infant. J Pediatr Adolesc Gynecol. 31(3):318-20, 2018
Lee SM et al: Antenatal prediction of neonatal survival in sacrococcygeal teratoma. J Ultrasound Med. 37(8):2003-9, 2018
Wessell A et al: Surgical treatment of a type IV cystic sacrococcygeal teratoma with intraspinal extension utilizing a posterior-anterior-posterior approach: a case report. Childs Nerv Syst. 34(5):977-82, 2018
Yoon HM et al: Sacrococcygeal teratomas in newborns: a comprehensive review for the radiologists. Acta Radiol. 59(2):236-46, 2018
Arisoy R et al: Prenatal diagnosis and outcomes of fetal teratomas. J Clin Ultrasound. 44(2):118-25, 2016
Eftekharzadeh S et al: Type IV sacrococcygeal teratoma displacing the urinary bladder: unique magnetic resonance imaging. Case Rep Urol. 2016:1423157, 2016
Hambraeus M et al: Sacrococcygeal teratoma: a population-based study of incidence and prenatal prognostic factors. J Pediatr Surg. 51(3):481-5, 2016
Kremer ME et al: Evaluation of chemotherapeutic sequelae and quality of life in survivors of malignant sacrococcygeal teratoma. Pediatr Surg Int. 32(3):261-8, 2016
Adekola H et al: The clinical relevance of fetal MRI in the diagnosis of type IV cystic sacrococcygeal teratoma--a review. Fetal Pediatr Pathol. 34(1):31-43, 2015
Dirix M et al: Malignant transformation in sacrococcygeal teratoma and in presacral teratoma associated with Currarino syndrome: a comparative study. J Pediatr Surg. 50(3):462-4, 2015
Sananes N et al: Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas - a cohort study and a literature review. Ultrasound Obstet Gynecol. 47(6):712-9, 2015
Coleman A et al: Sacrococcygeal teratoma growth rate predicts adverse outcomes. J Pediatr Surg. 49(6):985-9, 2014
Garg R et al: Sacrococcygeal malignant germ cell tumor (SC-MGCT) with intraspinal extension. J Pediatr Surg. 49(7):1113-5, 2014
Kremer ME et al: Evaluation of pregnancy and delivery in 13 women who underwent resection of a sacrococcygeal teratoma during early childhood. BMC Pregnancy Childbirth. 14:407, 2014
Ladino Torres MF et al: Spine ultrasound imaging in the newborn. Semin Ultrasound CT MR. 35(6):652-61, 2014
Partridge EA et al: Urologic and anorectal complications of sacrococcygeal teratomas: prenatal and postnatal predictors. J Pediatr Surg. 49(1):139-42; discussion 142-3, 2014
Yao W et al: Analysis of recurrence risks for sacrococcygeal teratoma in children. J Pediatr Surg. 49(12):1839-42, 2014
Shue E et al: Tumor metrics and morphology predict poor prognosis in prenatally diagnosed sacrococcygeal teratoma: a 25-year experience at a single institution. J Pediatr Surg. 48(6):1225-31, 2013
Yoneda A et al: Impact of the histological type on the prognosis of patients with prenatally diagnosed sacrococcygeal teratomas: the results of a nationwide Japanese survey. Pediatr Surg Int. 29(11):1119-25, 2013
Davenport KP et al: Pediatric malignancies: neuroblastoma, Wilm's tumor, hepatoblastoma, rhabdomyosarcoma, and sacroccygeal teratoma. Surg Clin North Am. 92(3):745-67, x, 2012
Peterson CM et al: Teratomas: a multimodality review. Curr Probl Diagn Radiol. 41(6):210-9, 2012
Yao MS et al: Sacrococcygeal teratoma in an adolescent. JBR-BTR. 95(5):322-4, 2012
Bartels SA et al: Presacral masses in children: presentation, etiology and risk of malignancy. Colorectal Dis. 13(8):930-4, 2011
Jan IA et al: Posterior sagittal approach for resection of sacrococcygeal teratomas. Pediatr Surg Int. 27(5):545-8, 2011
Shah RU et al: Imaging of pediatric pelvic neoplasms. Radiol Clin North Am. 49(4):729-48, vi, 2011
Dancel LD et al: Sacrococcygeal teratoma presenting as perineal and periumbilical discoloration (cullen sign). J Pediatr. 157(6):1041, 2010
Sy ED et al: Prognostic role of tumor-head volume ratio in fetal sacrococcygeal teratoma. Fetal Diagn Ther. 26(2):75-80, 2009
Heerema-McKenney A et al: Congenital teratoma: a clinicopathologic study of 22 fetal and neonatal tumors. Am J Surg Pathol. 29(1):29-38, 2005
Gatcombe HG et al: Primary retroperitoneal teratomas: a review of the literature. J Surg Oncol. 86(2):107-13, 2004
Isaacs H Jr: Perinatal (fetal and neonatal) germ cell tumors. J Pediatr Surg. 39(7):1003-13, 2004
Neubert S et al: Sonographic prognostic factors in prenatal diagnosis of SCT. Fetal Diagn Ther. 19(4):319-26, 2004
Urioste M et al: Malignant degeneration of presacral teratoma in the Currarino anomaly. Am J Med Genet A. 128(3):299-304, 2004
Zaccara A et al: Gait analysis in patients operated on for sacrococcygeal teratoma. J Pediatr Surg. 39(6):947-52; discussion 947-52, 2004
Graf JL et al: Fetal sacrococcygeal teratoma. World J Surg. 27(1):84-6, 2003
Hirose S et al: Fetal surgery for sacrococcygeal teratoma. Clin Perinatol. 30(3):493-506, 2003
Huddart SN et al: Sacrococcygeal teratomas: the UK Children's Cancer Study Group's experience. I. Neonatal. Pediatr Surg Int. 19(1-2):47-51, 2003
Avni FE et al: MR imaging of fetal sacrococcygeal teratoma: diagnosis and assessment. AJR Am J Roentgenol. 178(1):179-83, 2002
Lam YH et al: Thermocoagulation of fetal sacrococcygeal teratoma. Prenat Diagn. 22(2):99-101, 2002
O'Hara SM: Tumors of the pediatric genitourinary system. In Bragg et al: Oncologic Imaging. 2nd ed. W. B. Saunders. 779-811, 2002
Wakhlu A et al: Sacrococcygeal teratoma. Pediatr Surg Int. 18(5-6):384-7, 2002
Kamata S et al: Operative management for sacrococcygeal teratoma diagnosed in utero. J Pediatr Surg. 36(4):545-8, 2001
Wells RG et al: Imaging of sacrococcygeal germ cell tumors. Radiographics. 10(4):701-13, 1990
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Sacrococcygeal teratoma (SCT)
Synonyms
Teratoma, germ cell tumor of coccyx
Definitions
Teratomas are made up of various parenchymal cell types from > 1 germ layer, usually all 3
Tumors may contain hair, teeth, cartilage, & fat, among other tissues
SCT arises from pluripotential cells at caudal tip of notochord (coccyx)
Can grow both internally & externally (with latter being more common)
Both benign & malignant varieties exist
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
CT Findings
Ultrasonographic Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Selected References
Seilern Und Aspang J et al: Sacrococcygeal teratoma with intraspinal extension: a case series and review of literature. J Pediatr Surg. 55(10):2022-5, 2020
Baumgarten HD et al: Preemptive delivery and immediate resection for fetuses with high-risk sacrococcygeal teratomas. Fetal Diagn Ther. 45(3):137-44, 2019
Gebb JS et al: High tumor volume to fetal weight ratio is associated with worse fetal outcomes and increased maternal risk in fetuses with sacrococcygeal teratoma. Fetal Diagn Ther. 45(2):94-101, 2019
Ladenhauf HN et al: Sacrococcygeal teratoma presenting with vaginal discharge and polyp in an infant. J Pediatr Adolesc Gynecol. 31(3):318-20, 2018
Lee SM et al: Antenatal prediction of neonatal survival in sacrococcygeal teratoma. J Ultrasound Med. 37(8):2003-9, 2018
Wessell A et al: Surgical treatment of a type IV cystic sacrococcygeal teratoma with intraspinal extension utilizing a posterior-anterior-posterior approach: a case report. Childs Nerv Syst. 34(5):977-82, 2018
Yoon HM et al: Sacrococcygeal teratomas in newborns: a comprehensive review for the radiologists. Acta Radiol. 59(2):236-46, 2018
Arisoy R et al: Prenatal diagnosis and outcomes of fetal teratomas. J Clin Ultrasound. 44(2):118-25, 2016
Eftekharzadeh S et al: Type IV sacrococcygeal teratoma displacing the urinary bladder: unique magnetic resonance imaging. Case Rep Urol. 2016:1423157, 2016
Hambraeus M et al: Sacrococcygeal teratoma: a population-based study of incidence and prenatal prognostic factors. J Pediatr Surg. 51(3):481-5, 2016
Kremer ME et al: Evaluation of chemotherapeutic sequelae and quality of life in survivors of malignant sacrococcygeal teratoma. Pediatr Surg Int. 32(3):261-8, 2016
Adekola H et al: The clinical relevance of fetal MRI in the diagnosis of type IV cystic sacrococcygeal teratoma--a review. Fetal Pediatr Pathol. 34(1):31-43, 2015
Dirix M et al: Malignant transformation in sacrococcygeal teratoma and in presacral teratoma associated with Currarino syndrome: a comparative study. J Pediatr Surg. 50(3):462-4, 2015
Sananes N et al: Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas - a cohort study and a literature review. Ultrasound Obstet Gynecol. 47(6):712-9, 2015
Coleman A et al: Sacrococcygeal teratoma growth rate predicts adverse outcomes. J Pediatr Surg. 49(6):985-9, 2014
Garg R et al: Sacrococcygeal malignant germ cell tumor (SC-MGCT) with intraspinal extension. J Pediatr Surg. 49(7):1113-5, 2014
Kremer ME et al: Evaluation of pregnancy and delivery in 13 women who underwent resection of a sacrococcygeal teratoma during early childhood. BMC Pregnancy Childbirth. 14:407, 2014
Ladino Torres MF et al: Spine ultrasound imaging in the newborn. Semin Ultrasound CT MR. 35(6):652-61, 2014
Partridge EA et al: Urologic and anorectal complications of sacrococcygeal teratomas: prenatal and postnatal predictors. J Pediatr Surg. 49(1):139-42; discussion 142-3, 2014
Yao W et al: Analysis of recurrence risks for sacrococcygeal teratoma in children. J Pediatr Surg. 49(12):1839-42, 2014
Shue E et al: Tumor metrics and morphology predict poor prognosis in prenatally diagnosed sacrococcygeal teratoma: a 25-year experience at a single institution. J Pediatr Surg. 48(6):1225-31, 2013
Yoneda A et al: Impact of the histological type on the prognosis of patients with prenatally diagnosed sacrococcygeal teratomas: the results of a nationwide Japanese survey. Pediatr Surg Int. 29(11):1119-25, 2013
Davenport KP et al: Pediatric malignancies: neuroblastoma, Wilm's tumor, hepatoblastoma, rhabdomyosarcoma, and sacroccygeal teratoma. Surg Clin North Am. 92(3):745-67, x, 2012
Peterson CM et al: Teratomas: a multimodality review. Curr Probl Diagn Radiol. 41(6):210-9, 2012
Yao MS et al: Sacrococcygeal teratoma in an adolescent. JBR-BTR. 95(5):322-4, 2012
Bartels SA et al: Presacral masses in children: presentation, etiology and risk of malignancy. Colorectal Dis. 13(8):930-4, 2011
Jan IA et al: Posterior sagittal approach for resection of sacrococcygeal teratomas. Pediatr Surg Int. 27(5):545-8, 2011
Shah RU et al: Imaging of pediatric pelvic neoplasms. Radiol Clin North Am. 49(4):729-48, vi, 2011
Dancel LD et al: Sacrococcygeal teratoma presenting as perineal and periumbilical discoloration (cullen sign). J Pediatr. 157(6):1041, 2010
Sy ED et al: Prognostic role of tumor-head volume ratio in fetal sacrococcygeal teratoma. Fetal Diagn Ther. 26(2):75-80, 2009
Heerema-McKenney A et al: Congenital teratoma: a clinicopathologic study of 22 fetal and neonatal tumors. Am J Surg Pathol. 29(1):29-38, 2005
Gatcombe HG et al: Primary retroperitoneal teratomas: a review of the literature. J Surg Oncol. 86(2):107-13, 2004
Isaacs H Jr: Perinatal (fetal and neonatal) germ cell tumors. J Pediatr Surg. 39(7):1003-13, 2004
Neubert S et al: Sonographic prognostic factors in prenatal diagnosis of SCT. Fetal Diagn Ther. 19(4):319-26, 2004
Urioste M et al: Malignant degeneration of presacral teratoma in the Currarino anomaly. Am J Med Genet A. 128(3):299-304, 2004
Zaccara A et al: Gait analysis in patients operated on for sacrococcygeal teratoma. J Pediatr Surg. 39(6):947-52; discussion 947-52, 2004
Graf JL et al: Fetal sacrococcygeal teratoma. World J Surg. 27(1):84-6, 2003
Hirose S et al: Fetal surgery for sacrococcygeal teratoma. Clin Perinatol. 30(3):493-506, 2003
Huddart SN et al: Sacrococcygeal teratomas: the UK Children's Cancer Study Group's experience. I. Neonatal. Pediatr Surg Int. 19(1-2):47-51, 2003
Avni FE et al: MR imaging of fetal sacrococcygeal teratoma: diagnosis and assessment. AJR Am J Roentgenol. 178(1):179-83, 2002
Lam YH et al: Thermocoagulation of fetal sacrococcygeal teratoma. Prenat Diagn. 22(2):99-101, 2002
O'Hara SM: Tumors of the pediatric genitourinary system. In Bragg et al: Oncologic Imaging. 2nd ed. W. B. Saunders. 779-811, 2002
Wakhlu A et al: Sacrococcygeal teratoma. Pediatr Surg Int. 18(5-6):384-7, 2002
Kamata S et al: Operative management for sacrococcygeal teratoma diagnosed in utero. J Pediatr Surg. 36(4):545-8, 2001