Beverly Coleman MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To analyze the sonographic features of sacrococcygeal teratoma (SCT) to determine which are good or poor prognostic indicators for fetal outcome. Methods and Materials: From February 1997 to March 2003, 39 pregnant patients were referred to the Fetal Center for Diagnosis and Treatment with a suspected complication of fetal SCT. The diagnosis was confirmed in 33 cases, 30 singleton and 3 twin gestations. The ultrasound protocol consisted of determination of SCT type, volume estimation, classification as > 50% solid, >50% cystic or mixed, power Doppler assessment of blood flow, fetal gender, placental thickness and amniotic fluid index. Results: The mean maternal age was 29.4 years and gestational age 23 weeks 3 days. SCT features included the following: 26 Type I, 3 Type II and 4 Type III; mean volume on initial scan, 320 ccs; 26 > 50% solid, 4 > 50% cystic and 3 equally cystic and solid; focal calcifications were present in 15; 28 were hypervascular and 5 had little or no flow; suggested feeing vessels were evident in 20 cases included the iliac and/or middle sacral arteries. Fetal gender was 24 female, 3 male and 6 indeterminate. 17 had placentomegaly with an AP diameter >5mm more than a menstrual age in weeks. To date, 16 patients had or developed complications including nonimmune hydrops, fetal circulatory overload (cardiomegaly, hepatomegaly, dilated IVC, hydrometrocolpos, etc.) and/or hydronephrosis. Nine patients had polyhydramnios and four oligohydramnios. The mean SCT volume for complicated cases was 521.5 cc compared to 49.9 cc for uncomplicated cases, which was statistically significant (P=.000035). 4/4(100%) of the predominantly cystic tumors had no complications. The difference in complications between solid and cystic mass populations was shown to be significant (P=0.05) by Fisher's exact test. Fourteen patients were followed at the fetal center and 100% increased in tumor volume over ti Conclusion: Pregnancies complicated by predominantly solid SCT are at significant risk of development of complications compared to predominantly cystic SCT. Large tumors with rapid growth rates are more likely to result in complications. These features can help in determining the frequency of serial sonographic monitoring, patient counseling, and delivery planning.     (B.G.C. is a consultant for Phillips Medical.)

Coleman MD, B, Sacrococcygeal Teratoma: Sonographic Evaluation with Grey Scale and Power Doppler.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3107478.html