Sacrococcygeal teratoma Q&A
If your baby develops a spinal tumor in the womb, Dr. Mehra and his team can provide the care you and your baby need through accurate diagnoses, carefully coordinated treatment plans, and unparalleled surgical expertise. Throughout your care, we bring together the experts you need from across the Advocate Children’s Hospital network.
What is a sacrococcygeal teratoma?
A sacrococcygeal teratoma (SCT) is a tumor that develops during early pregnancy at the base of a baby’s spine. Although SCTs are usually benign (not cancerous), they can still grow very large and cause problems. SCTs can grow outside or inside the baby’s body, or, in a combination with inside and outside components.
SCTs usually contain various amounts of both solid tissue and cysts (fluid-filled sacs). Tumors that have more cysts typically grow slowly and are easier to remove. Tumors with more solid tissue can take blood away from your growing baby and cause their heart to work harder than normal.
What causes a sacrococcygeal teratoma?
The causes of sacrococcygeal teratomas are unknown. SCTs are germ cell tumors, meaning they grow from cells that form the reproductive organs.
Sacrococcygeal teratoma symptoms and signs
The signs and symptoms of SCT vary depending on the tumor’s size and location. Doctors usually identify SCTs during a routine ultrasound in pregnancy. Related signs in the mother include:
- Abnormally large uterus, usually due to excess amniotic fluid (liquid surrounding your baby in a protective membrane)
- High levels of alpha-fetoprotein in a blood test
How is SCT diagnosed?
Often times, SCT's are identified on routine prenatal ultrasounds. If SCT is suspected, additional tests may be needed to confirm a diagnosis and gather information needed for treatment. Additional testing may include:
- Targeted fetal ultrasound to more closely examine the spine and tumor
- Fetal Doppler ultrasound to assess blood flow to the tumor
- Ultrafast fetal MRI to measure the tumor and determine its makeup
- Fetal echocardiogram (heart ultrasound) to check for heart problems
If necessary, you may also be referred to our genetics program for a consultation and evaluation.
How is sacrococcygeal teratoma treated?
Treatment options vary depending on the size of the tumor and how it’s affecting you and your baby. If the tumor is small and your baby’s heart is healthy, the tumor can be removed after birth. Through careful monitoring, Dr. Mehra and his team use repeat scans and images to stay informed about the size of the tumor and it's affects on mother and baby. When indicated, Dr. Mehra can safely deliver a baby with a teratoma before the tumor causes permanent damage to the baby's other vital organ systems.
Sacrococcygeal teratoma treatment in the womb
As with many diagnoses, SCT can lead to other secondary conditions that create additional physical stress for mother and baby.
With large SCTs, hydrops fetalis may develop, requiring fetal surgery before delivery. Dr. Mehra's education and surgical experience come together to provide the single best care option for you and your child. Dr. Mehra is highly skilled in minimallly invasive prodedures as well as open fetal surgery and is prepared to provide care at any level his patients need.
If necessary, fetal blood transfusions can be arranged to be sure your baby has a continuos supply of healthy blood and nutrients in the womb. Other complications can include excessive amniotic fluid, which can be drained to relieve pressure for mother and baby. Accurate diagnosis, careful monitoring, and competent care teams come together to provide all necessary care, including patient education, prenatal/perinatal care, and post pardum support.
Learn more about fetal surgery here.
Sacrococcygeal teratoma treatment at birth
Giving birth is almost always full of surprises. While this condition/diagnosis may be surprising for new parents, Dr. Mehra's extensive surgical expertise and consistent communication with his team and his patients come together in a way that eliminates as many surprises as possile for everyone involved. From the onset of care, Dr. Mehra and his team work dilligently to monior, assess and treat conditions like SCT. Delivery options (vaginal/cesarean) will be discussed with family preferences taken into account, and feedback is provded to help parents make the most informed care decisions that keep both mother and baby safe. In addition to surgical removal after baby is born, Dr. Mehra can also perform an EXIT (ex utero intrapartum) to evaluate the SCT while the baby is still attached to the placenta, to decide whether to remove the SCT immediately or wait and take it out later, when the baby is breathing and eating well. No two cases are ever the same, but a calm, confident, skilled provider can make difficult moments more manageable.
Sacrococcygeal teratoma follow-up care
After surgery, Dr. Mehra provides ongoing care to avoid complications and provide the best outcomes possible. At times, some children will contend with bowel and/or bladder dysfunction, tumor recurrence, and other concerns that impact the child's quality of life. Through consistent monitoring after delivery and surgical correction of SCT, Dr. Mehra and his team help families carefully navigate all potential treatment options as baby continues to grow and develop.
Contact our office to learn more about how Dr. Mehra can help with a sacrococcygeal teratoma diagnosis.