Department of Radiotherapy, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China.
Medicine (Baltimore). 2022 Dec 30;101(52):e32410. doi: 10.1097/MD.0000000000032410.
Sacrococcygeal teratomas (SCT) in adults are extremely rare, and most SCTs are located either mainly outside the pelvis, with a small number of intrapelvic components, or mostly in the pelvis (types III and IV). The etiology of teratomas remains unknown. Most teratomas are benign, and approximately 1 to 2% of teratomas undergo malignant transformation, including squamous cell carcinoma, adenocarcinoma, sarcoma, and other malignancies. Most SCTs grow insidiously, and their symptoms are not easily detected in the early stages. Some cases may only be discovered through physical examination or compression symptoms when the tumor reaches a detectable size. Computed tomography and magnetic resonance imaging have high detection rates for presacral space-occupying lesions and can provide imaging details with guiding significance for the selection of surgical methods. Surgical resection is the preferred treatment option for SCT and can determine the pathological type. Common sacrococcygeal malignancies are mainly immature teratomas and mature teratomas. When the presence of malignant components is confirmed, the treatment model should be adjusted according to pathological type.
成人骶尾部畸胎瘤(SCT)极为罕见,大多数 SCT 主要位于骨盆外,少数位于骨盆内(III 型和 IV 型)。畸胎瘤的病因尚不清楚。大多数畸胎瘤为良性,约 1%至 2%的畸胎瘤发生恶性转化,包括鳞状细胞癌、腺癌、肉瘤和其他恶性肿瘤。大多数 SCT 生长隐匿,早期症状不易察觉。一些病例可能仅通过体格检查或当肿瘤达到可检测大小时因肿瘤压迫症状才被发现。计算机断层扫描和磁共振成像对骶前占位性病变的检出率较高,可为手术方法的选择提供具有指导意义的影像学细节。手术切除是 SCT 的首选治疗方法,可以确定病理类型。常见的骶尾部恶性肿瘤主要为未成熟畸胎瘤和成熟畸胎瘤。当确认存在恶性成分时,应根据病理类型调整治疗模式。