109 Sacrococcygeal teratoma: long-term outcome in paediatric population. (15th December 2021) - Dhaiban, Manal
Abstract : Background: Sacrococcygeal teratoma (SCT) is a rare extragonadal germ cell tumour that is mostly diagnosed during infancy and early childhood. This study aims to report our experience in management of SCT and the long-term outcome over 20-years period. Methods: Retrospective review was conducted of all patients with SCT between the year 2000 and 2020. We looked at patient demographics, age at diagnosis, management options, histological features, survival rate, recurrences and late outcomes. Result: A total of 46 patients (71% females) were treated for SCT at our institute. Majority were diagnosed before 1st year of age (65%). Associated anomalies were present in 30% of our patients. All underwent a multidisciplinary team approach and upfront surgical resection was performed in 34 (74%) patients. Almost all of our patients (97.8%) had documented tumour resection with coccygectomy. Pathology revealed mature, immature, and malignant yolk sac tumour (YST) in 23 (50%), 10 (22%), and 13 (28%) patients, respectively. Recurrence was detected as early as 6 months and up to 3 years post resection. it occurred in 5 of 23 patients with mature teratoma (21.7%), 4 of 13 YST (30%), and 1 of 10 immature teratoma. In this cohort of patients, the overall survival rate was 95.6%. The two deaths in our series were due to over whelming lung metastasis and increased burden of disease. Follow up duration range from 4.9 months -17.5 years (median of 4.2 years). Bladder or bowel dysfunction (BBD) was present in 14 of 35 (40%) patients on long term follow up. We had 2 patients with reported unsightly scar that required revision. Conclusion: Parental counselling about functional outcomes and the need for long term follow up are crucial in management of children with SCT. We recommend formal routine screening for BBD in follow up.