Pediatric Sacrococcygeal Teratoma: A ۱۲-Year Clinical Experience from Mofid Children's Hospital neonatology

Background: Sacrococcygeal teratoma (SCT) is the most common extragonadal germ cell tumor in neonates and infants. While many cases are benign, SCTs can undergo malignant transformation or recur after surgery, posing significant challenges for long-term care. We aimed to review a ۱۲-year experience with pediatric SCT at a single tertiary center in Tehran, Iran, to evaluate outcomes and identify factors associated with recurrence. Method: We reviewed records of ۲۴ pediatric patients who underwent SCT resection between January ۲۰۱۱ and January ۲۰۲۳. Demographic, diagnostic, treatment, and follow-up data were collected. Survival outcomes, including progression-free survival (PFS) and overall survival (OS), were estimated using the Kaplan-Meier method, with group comparisons performed by the log-rank test. Results: Of the ۲۴ patients, ۱۷ (۷۰.۸%) were female. The median age at diagnosis was ۱۱ months, and only one case (۴.۲%) was detected antenatally. Mature teratoma was the most common histology (۵۸.۳%), followed by yolk sac tumor (۲۹.۲%). Malignancy was significantly associated with late diagnosis (۱ year; ۵۴.۶% vs. ۷.۷% in ۱ year, p = ۰.۰۲۳). Among ۱۷ patients with follow-up, recurrence occurred in ۷ (۴۱.۲%), most commonly as yolk sac tumor (۷۱.۴%). The median PFS for the entire cohort was ۲۶.۴ months. Patients with yolk sac tumors demonstrated a shorter median PFS (۹ months) compared with those with mature teratomas (۲۶.۴ months), although this difference represented a nonsignificant trend (p = ۰.۳۷). Only one patient (۴.۲%) died during follow-up. Conclusion: Our findings highlight a low antenatal detection rate and a delayed median age at diagnosis in this cohort. Late presentation was strongly associated with malignant SCT. The high recurrence rate and poor prognosis of yolk sac tumors underscore the need for early recognition, complete resection, and vigilant long-term surveillance, recommended for at least three years regardless of initial histology.

کلیدواژه ها:

Sacrococcygeal teratoma ، Pediatric germ cell tumors ، Yolk sac tumor ، Pediatric oncology