DOI: https://dx.doi.org/10.18203/2349-2902.isj20221903
Published: 2022-07-26

A case report of large adult sacrococcygeal teratoma with literature review

Aisha Akhtar, Karla M. Ruiz-Vega, George Y. Apostolides

Abstract


Sacrococcygeal teratomas rarely present in adulthood. Due to its rarity, accurate diagnosis is a clinical dilemma in adults. The patient was a 41-year-old female who presented with pelvic pain, low back pain radiating to the legs and chronic constipation.  The patient underwent a CT scan which demonstrated a 6 cm presacral multiloculated mass compressing rectum. Prior to presentation at our clinic, she had an EUS and biopsy by gastroenterology, followed by diagnostic laparoscopy due to her past medical history of endometriosis.  Her workup was negative for gynaecologic pathology which led to a surgical referral. We evaluated the images and took her to the operating room for posterior paracoccygeal retrorectal mass resection with coccygectomy and intraoperative flexible sigmoidoscopy. She had complete excision for pathologically proven mature 9 cm teratoma. Sacrococcygeal teratoma is rare in adults. A high index of suspicion is required for diagnosis. It should be in the differential diagnosis when dealing with presacral masses in adults. Complete excision is the treatment of choice.


Keywords


Sacrococcygeal teratoma, Endometriosis, Coccygectomy

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References


Afuwape OO, Ogundoyin OO, Ogunlana DI, Adeleye AO. Adult sacrococcygeal teratoma: a case report. Ghana Med J. 2009;43(1):40-2.

Valdiserri RO, Younis EJ. Sacrococcygeal teratomas: a review of 68 cases. Cancer. 1981;48:217-21.

Ghosh J, Eglinton T, Frizelle FA, Watson AJ. Presacral tumours in adults. Surgeon. 2007;5(1):31-8.

Mindaye ET, Kassahun M, Prager S, Tufa T. Adult case of giant sacrococcygeal teratoma: case report. BMC Surg. 2020;20:295.

Ng EW, Porcu P, Loehrer PJS. Sacrococcygeal teratoma in adults. Cancer. 2009;86:1198-202.

Gajula B, Srikanth K, Huda F, Sandhu H, Basu S. A Giant Sacrococcygeal Teratoma in an Adult Male: A Case Report. Cureus. 2011;13(3):e14181.

Mourad AP, De Robles MS, O'Toole S, Paver E, Winn RD. A case of an asymptomatic sacrococcygeal teratoma diagnosed in adulthood. J Surg Case Rep. 2020;2020(11):462.

Luk SY, Tsang YP, Chan TS, Lee TF, Leung KC. Sacrococcygeal teratoma in adults: case report and literature review. Hong Kong Med J. 2011;17:417-20.

Sukhadiya MV, Das U. Laparoscopic approach to type iv sacrococcygeal teratoma in an adult. Indian J Surg. 2015;77:62-3.

Cody HS, Marcove RC, Quan SH. Malignant retrorectal tumors: 28 years' experience at Memorial Sloan-Kettering Cancer Center. Dis Colon Rectum. 1981;24:501-6.