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Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
Clinical History:
The patient was a 32 week premature female born at an outside hospital who was diagnosed with a large sacral soft tissue mass at birth. The antenatal history was remarkable for polyhydramnios diagnosed via prenatal ultrasound, pregnancy induced hypertension, and removal of a maternal dermoid during pregnancy.
Clinical Physical Exam:
Large exophytic soft tissue mass in the region of the sacrum.
Clinical Labs:
Non-contributory
Clinical Differential Diagnosis:
Sacrococcygeal teratoma.
Imaging Findings:
Babygram from the first day of life showed a huge soft tissue mass arising from the gluteal region.
Imaging Differential Diagnosis:
Sacrococcygeal teratoma
Operative Findings:
The patient was taken to the operating room on the second day of life. The sacral mass was excised.
Pathological Findings:
Examination of the surgical specimen revealed it to be 22 x 18 x 12 cm in size and was composed of multiple cysts within it. A single soft tissue focus that resembled brain tissue was noted. No hair or teeth were seen. A microscopic foci of embryonal carcinoma and endodermal sinus tumor was noted. The findings were consistent with a diagnosis of immature teratoma.
Final Diagnosis:
Sacrococcygeal Teratoma
Follow-up and Prognosis:
Postoperatively, the patient developed a sciatic nerve palsy and poor anal control and underwent a perineal reconstruction at 16 months of age.
Similar Cases:
Case 43
References:
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