Sacro-coccygeal teratoma: about an observation and diagnostic process

Abstract

Sacro-coccygeal teratomas (SCT) are the most common benign fetal tumors with an incidence of about 1/3000 births. Currently, thanks to advances in imaging techniques, diagnosis can be made in the first trimester of pregnancy. We report the case of Mrs. JF, a 25-year-old primigravida female, with no significant pathological history, a primigravida who had consulted the radiology department of the maternity hospital of Kairouan, at 16 weeks of amenorrhea, to do a prenatal ultrasound. On examination, it was a progressive monofetal pregnancy of 16 weeks of amenorrhea, with discovery of a cystic formation about 3 cm in diameter, well limited, located in the sacro-coccygeal region. A complementary Magnetic Resonance Imaging (MRI) scan showed a well-defined mass measuring 24x17mm, which was hyper intense on T1, attached to the caudal end of the fetus, at the presacral space, with an extension downwards to the soft parts, with no endopelvic component or fat component. In the presence of these radiological data, a sacro-coccygeal teratoma was first suspected, but a meningocele could not be formally eliminated, due to the limits of these examinations. The collegial decision was therefore to authorize the continuum of the pregnancy. The patient was monitored on an outpatient basis with regular clinical and ultrasound check-ups. Pregnancy continued up to 40 weeks. The baby was operated on, at 2 weeks of age, with complete removal of the tumor. The pathological examination of the surgical specimen was in favor of a mature cystic sacrococcygeal benign teratoma, without signs of malignancy.