Padilla Benjamin E, Vu Lan, Lee Hanmin, MacKenzie Tippi, Bratton Barbara, O'Day Maura, Derderian Sarkis
University of California San Francisco School of Medicine, San Francisco, CA, USA.
Pediatr Surg Int. 2017 Nov;33(11):1189-1194. doi: 10.1007/s00383-017-4132-1. Epub 2017 Sep 11.
Sacrococcygeal teratoma (SCT) is a rare childhood malignancy. Although overall survival is favorable, recurrent tumors are associated with poor outcomes. As most recurrences occur within 3 years of presentation, the utility of long-term surveillance is uncertain.
Patients with SCTs evaluated and managed by our pediatric surgery department between 1986 and 2013 were included. Details pertaining to laboratory values, operative findings, tumor histology, management, recurrence, and outcomes were recorded and analyzed.
During the study period, 40 children with the diagnosis of SCT were managed by our practice. Five (13%) developed a recurrence. The median age at the initial resection was day of life two (range day of life 0-2.5 years). The median time to recurrence was 5 years (range 5 months-15 years). Among those with recurrences, mature teratoma was the most common histological type on the initial resection (n = 3), with yolk sac and immature teratomas comprising the other two. At the time of recurrence, three patients had mature teratomas, and all are alive and well following resection. Two patients had yolk sac tumors at the time of recurrence and both died.
SCT can recur many years after the initial resection. Our findings suggest that all patients with SCT should be closely followed into adulthood.
骶尾部畸胎瘤（SCT）是一种罕见的儿童恶性肿瘤。尽管总体生存率良好，但复发性肿瘤的预后较差。由于大多数复发发生在就诊后3年内，长期监测的作用尚不确定。
纳入1986年至2013年间由我们儿科外科评估和治疗的SCT患者。记录并分析有关实验室检查值、手术发现、肿瘤组织学、治疗、复发和结局的详细信息。
在研究期间，我们诊治了40例诊断为SCT的儿童。5例（13%）出现复发。初次切除时的中位年龄为出生后第2天（范围为出生后0 - 2.5年）。复发的中位时间为5年（范围为5个月 - 15年）。在复发患者中，初次切除时最常见的组织学类型是成熟畸胎瘤（n = 3），另外两种是卵黄囊瘤和未成熟畸胎瘤。复发时，3例患者为成熟畸胎瘤，切除后均存活且情况良好。2例患者复发时为卵黄囊瘤，均死亡。
SCT在初次切除多年后仍可复发。我们的研究结果表明，所有SCT患者都应密切随访至成年。
