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SMA Syndrome
Joseph Junewick, MD FACR
over 5 years ago
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ARSt Case Repository

Fetal Sacrococcygeal Teratoma

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

28 year old female with fetal pelvic mass on prenatal US.


Case Images


Diagnosis

Fetal Sacrococcygeal Teratoma

Findings

MR – Sagittal FIESTA images demonstrate an exophytic and endophytic solid and cystic (predominantly cystic) pelvic mass. Note the anterior-superior displacement of the urinary bladder.

Discussion

Sacrococcygeal teratoma is the most common tumor of the fetus and the neonate, with a reported incidence of one in 35,000 to 40,000 live births. Malignant degeneration, the primary cause of death in postnatal sacrococcygeal teratoma, is rare in utero. The high mortality rate of fetal sacrococcygeal teratoma is attributed to tumor mass and associated dystocia, preterm labor caused by secondary polyhydramnios, and development of hydrops and placentomegaly (secondary to high-output cardiac failure associated with arteriovenous shunting). Optimal management of fetal sacrococcygeal teratoma requires accurate imaging of the precise intrapelvic and intraabdominal extent of tumor, the content of the tumor, and the physiologic effects of tumor compression on the pelvic organs or bone structure. MRI is generally superior to sonography on all of these accounts.

Reference

Danzer E, Hubbard AM, Hedrick HL, Johnson MP, Wilson RD, Howell LJ, Flake AJ, Adzick NS. Diagnosis and Characterization of Fetal Sacrococcygeal Teratoma with Prenatal MRI. AJR 2006; 187:W350-W356.



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