Great Ormond Street Hospital for Children, Department of Paediatric Surgery-Specialist Neonatal and Paediatric Surgery, NHS Foundation Trust, Great Ormond Street, London WC1N 3JH.
Great Ormond Street Hospital for Children, Department of Paediatric Surgery-Specialist Neonatal and Paediatric Surgery, NHS Foundation Trust, Great Ormond Street, London WC1N 3JH.
J Pediatr Surg. 2020 Oct;55(10):2022-2025. doi: 10.1016/j.jpedsurg.2020.02.003. Epub 2020 Feb 15.
Sacrococcygeal teratoma (SCT) is the most common teratoma in neonates and arises from the coccyx. SCT with intraspinal invasion is extremely rare and only reported in a few cases.
37 patients with SCT were identified at our institution between 2000 and 2018. Three of these patients had SCT with intraspinal extension. A literature review for intraspinal extension associated with SCT, including mode of diagnosis, presentation, surgical approach and neurological sequelae, between 1993 and 2018 was also conducted.
The authors report three cases of infants who were antenatally and/or postnatally diagnosed with a sacrococcygeal teratoma extending into the spinal canal. We illustrate the challenges of accurate diagnosis and therapeutic management. Postnatal magnet resonance imaging (MRI) was the best method to define spinal anatomy and extension of the tumors prior to surgery. Management with a multidisciplinary team approach including neuroradiology, neurosurgery and general surgery was used in our two most recent patients. The literature review yielded 6 cases of SCT with intraspinal extension.
Intraspinal extension in SCT is rare but should be excluded at birth before attempting any resection. In case of positive spinal invasion on Ultrasonography (US), MRI is essential to plan for surgery and possible laminectomy to be able to perform a radical resection of this congenital tumor. We recommend this multidisciplinary approach.
Level IV.
骶尾部畸胎瘤（SCT）是新生儿中最常见的畸胎瘤，起源于尾骨。伴有椎管内侵犯的 SCT 极为罕见，仅在少数病例中报道过。
本研究回顾性分析了 2000 年至 2018 年在我院确诊的 37 例 SCT 患者，其中 3 例患者的 SCT 伴有椎管内延伸。同时还对 1993 年至 2018 年间与 SCT 相关的椎管内延伸的文献进行了综述，包括诊断方式、表现、手术方法和神经后遗症。
作者报告了 3 例婴儿的病例，这些婴儿在产前和/或产后被诊断为骶尾部畸胎瘤延伸至椎管内。我们展示了准确诊断和治疗管理的挑战。术后 MRI 是在手术前确定脊柱解剖结构和肿瘤延伸的最佳方法。在最近的 2 例患者中，采用了包括神经放射科、神经外科和普通外科在内的多学科团队方法进行管理。文献复习共发现 6 例伴有椎管内延伸的 SCT 病例。
SCT 伴有椎管内延伸罕见，但在尝试任何切除术前应在出生时排除。如果超声（US）检查提示有阳性的脊柱侵犯，MRI 对于计划手术和可能的椎板切除术以实现对这种先天性肿瘤的根治性切除是必不可少的。我们建议采用这种多学科的方法。
IV 级。
