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In utero management of sacrocoxygeal teratoma and postnatal resection
Manejo in útero de teratoma sacrocoxigeo y resección postnatal

Cristian Sosa, Pablo Mascareño, Gustavo Rosas, Laura Adriana Amarilla, Lea Edith Acevedo, Andressa Ricardo, Petronilo Sosa
2019 Anales de la Facultad de Ciencias Médicas (Asunción)  
Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons ABSTRACT We describe a case of giant sacrococcygeal teratoma (SCT) diagnosed at 21 weeks of gestation. Due to the signs of vascular steal and fetal heart failure at 24 weeks of gestation, sclerosis of the nutrient vessel was proposed by a laser diode. The procedure was performed by percutaneous puncture guided by ultrasound on three occasions, at 25 weeks, at 27 and at 30 weeks. There was no immediate side effect
more » ... mediate side effect after treatment. The devascularization was partial, due to the peripheral hypervascularization of the mass. Signs of fetal heart failure normalized after 1 week with decreased tumor growth. Delivery was performed by cesarean at 34 weeks, due to premature rupture of the membranes and advanced labor in pelvic presentation. Six hours after birth, tumor excision was performed using a conventional technique, in which SCT with a total weight of 630 grs was completely removed, material that was sent to the pathological anatomy. Final diagnosis was immature teratoma grade III. Conclusions: Minimally invasive surgery with sclerosis of the nutrient vessel seems to improve the perinatal outcome in cases of high-risk fetal SCT. Identification and early treatment can give us a successful outcome.
doi:10.18004/anales/2019.052.03.17-024 fatcat:3lzba6e7pzbxnj7x2fn6bbryle