Abubakar A M, Nggada H A, Chinda J Y
Paediatric Surgery Unit, Department of Surgery, University of Maiduguri Teaching Hospital, P.O. Box 4088, Maiduguri, Borno State, Nigeria.
Pediatr Surg Int. 2005 Aug;21(8):645-8. doi: 10.1007/s00383-005-1486-6. Epub 2005 Oct 13.
Although sacrococcygeal teratomas are rare, there have been several reports from various parts of Nigeria, outside the Northeast region. This report reviews the experience with this tumour from the northeastern part of Nigeria. A retrospective study of 21 children with histologically confirmed sacrococcygeal teratoma managed in 18 years. Over the 18-year-period, 21 histologically confirmed cases of sacrococcygeal teratoma were seen-80% were girls. Thirteen (60.9%) presented during the neonatal period. Eighteen patients presented with benign sacrococcygeal teratoma while three patients and a recurrence from an initial benign tumour had malignant sacrococcygeal teratoma. All malignant tumours had a significant presacral component. There were associated congenital malformations in 3 (14.3%) of the patients. All the benign tumours were resectable. Using the American Academy of Pediatrics (Altman's) classification, 13 patients were type I, 5 patients type II, 3 patients type Ill and none was for type IV. The commonest post-operative complication was wound infection in six patients. Others were wound dehiscence in three and post-operative diarrhoea in two patients. Three deaths were recorded in this series. The size of mass greater than 5 cm did not correlate with the incidence of post-operative complications (P=0.367). The post-operative follow-up was very poor; but there was a recurrence in a girl, two-years after the initial surgery. Our study revealed that most of our patients with sacrococcygeal teratoma present early to hospital with benign lesions and the immediate post-operative results were excellent. However, the follow-up was poor as such long-term post-operative results are difficult to study. It is to be recommended that sacrococcygeal teratoma presenting early to hospital should have prompt surgical intervention.
尽管骶尾部畸胎瘤很罕见，但尼日利亚除东北地区外的其他各地均有相关报道。本报告回顾了尼日利亚东北部地区治疗该肿瘤的经验。对18年间21例经组织学确诊的骶尾部畸胎瘤患儿进行回顾性研究。在这18年期间，共发现21例经组织学确诊的骶尾部畸胎瘤病例，其中80%为女孩。13例（60.9%）在新生儿期发病。18例患者为良性骶尾部畸胎瘤，3例患者及1例最初为良性肿瘤复发的患者患有恶性骶尾部畸胎瘤。所有恶性肿瘤均有明显的骶前成分。3例（14.3%）患者伴有先天性畸形。所有良性肿瘤均可切除。根据美国儿科学会（奥特曼分类法），13例患者为I型，5例为II型，3例为III型，无IV型。最常见的术后并发症是6例患者出现伤口感染。其他并发症包括3例伤口裂开和2例患者术后腹泻。本系列记录了3例死亡病例。肿块大小大于5 cm与术后并发症发生率无关（P=0.367）。术后随访情况很差；但有1名女孩在初次手术后两年复发。我们的研究表明，大多数骶尾部畸胎瘤患者早期因良性病变入院，术后即刻效果良好。然而，随访情况很差，因此难以研究长期术后结果。建议早期入院的骶尾部畸胎瘤患者应立即接受手术干预。
