Giant adult malignant sacrococcygeal teratoma. Successful treatment by combined abdominosacral resection.

This report describes the successful removal of the largest adult sacrococcygeal teratoma (18.75 kg) the authors could find on record. The patient was 58 years of age. The tumor had been present at birth and had been biopsied at the time of her cesarean section 34 years earlier without further treatment. Special planning was necessary for moving and positioning the patient for operation to prevent injury due to the size and weight of the tumor. A combined abdominosacral resection with preliminary ligation of the internal iliac arteries and a diversionary colostomy were performed without difficulty or undue blood loss. The defect was closed primarily and drained. The tumor proved to be malignant on pathologic examination.