Sacrococcygeal Teratoma
What is a sacrococcygeal teratoma?
How is it diagnosed?
About the operation
After the operation
Caring for your child at home
When to call the doctor
What is a sacrococcygeal teratoma?
Sacrococcygeal teratoma (SCT) is a tumor that develops before birth and grows from a baby's coccyx — more commonly known as the "tailbone." The tumor is usually covered with skin, but may be covered by a thin, transparent tissue called a membrane. Most tumors have many blood vessels coming through them. They come in many different sizes, and sometimes they may grow outward from the back or toward your child's stomach.
Doctors group SCT tumors according to their location and severity:
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Type I tumors are external (outside the body) tumors and are attached to the tailbone.
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Type II tumors have both internal (inside the body) and external parts.
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Type III tumors can be seen from the outside, but most of the tumor is inside your child's abdomen.
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Type IV tumors, the most serious tumors, can't been seen from the outside. They are inside the body at the tailbone level.
How is it diagnosed?
Some tumors can be diagnosed by ultrasound before your child is born. Your may be referred to The Center for Fetal Diagnosis and Treatment for further monitoring of you and your baby prior to birth. Your baby may need fetal surgery for a sacrococcygeal teratoma (SCT).
Other tumors may not be visible until after your baby is born. Your child may also have symptoms — such as being unable to urinate or have a bowel movement — because the tumor is pressing on her bladder or rectum. On the other hand, some children have no symptoms at all.
About the operation
If your child has an SCT tumor, he'll need surgery. During the surgery, the surgeon will remove both the tumor and your child's tailbone. The doctor has to remove the tailbone because the tumor grows from it, and if it's not removed, the tumor may grow back.
If the tumor is in your child's abdomen, the surgeon may need to make two incisions, one in his buttocks and one in his abdomen.
After the operation
After surgery, your child will go back to her hospital room. Here's what to expect:
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Incision: your child will have sutures over the incision, then a gauze dressing. The sutures will be removed approximately one to two weeks after surgery. Initially after surgery, your child will be in a prone position for a few days up to one week to give the incision time to heal. Sometimes, thin strips of tape, called STERI-STRIPS, are placed after sutures are removed.
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Pain relief: your child will get pain medication as she needs it. When she first comes back to her room after surgery, she may need narcotic medication — such as morphine or Versed; she'll get these through an intravenous (IV) line. Once she's able to drink, she can take acetaminophen (TYLENOL) by mouth.
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Fluids: until your baby can drink, she'll get needed fluids — as well as antibiotics to prevent infection — through her IV.
She'll be discharged from the hospital when:
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Her incision is healing well
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She doesn't have a fever
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She is able to drink, urinate and have a bowel movement
Caring for your child at home
Once your child comes home, he may have formula or breast milk. You may also give him acetaminophen (TYLENOL) — according to his doctor's instructions — for any pain he may have.
The STERI-STRIPS will fall off on their own. Once the edges begin to curl up, you may remove them.
Take additional care when cleaning your child's bottom, because the incision area near your child's rectum can become infected if you don't keep it clean. You may give your child a tub bath one to two weeks after surgery.
You'll need to take your child for a follow-up appointment with the surgeon two weeks after he comes home from the hospital, then every few months until he's 2 and then every year after that. At each visit, your child will have a blood test called an alpha-fetoprotein (AFP) test, which checks for the return of the tumor.
When to call the doctor
Please call your child's doctor (at Children's Hospital, call 215-590-2730) if:
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Your child develops a fever greater than 101 degrees F
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Your child isn't urinating as often as usual (decreased number of wet diapers)
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Your child is vomiting
Reviewed by: Surgical Advanced Practice Nurses
Date: November 2008
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