Introduction. When revealing a sacrococcygeal tumor in pediatric patient (especially newborn), a germ-cell tumor (GCT) (mostly teratoma) should be suspected. Just observation in cases of such tumors of small size, which might look as an option, cannot be recommended. Aim of study: to reveal the peculiarities of diagnostics and treatment of small-sized sacrococcygeal GCT in newborns. Materials and methods. We analyzed the data of charts of patients with sacrococcygeal GCT from 2 clinics of St.

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... tersburg (pediatric surgical hospital CCMCSCHMT and pediatric oncological department of St. Petersburg Oncocenter) for past 15 years (20052019). Among 55 newborn patients the size of tumor varied, comprising 14 giant (over 14 cm in diameter), 18 large (1014 сm in diameter), 21 medium-sized (39 cm), and 2 small-sized teratomas (under 3 cm in diameter). Results. In both cases of small-sized GCT prenatal ultrasound was unable to reveal the tumor. Those patients appeared by surgeon occasionally (being either not transferred to hospital from the delivery house after birth or coming because of some other reason). Both patients underwent radical surgery with excision of coccyx (histological diagnosis being mature teratoma) and are still under observation of oncologist (with no signs of relapse during 6 months and 21 months). During the same period (20052019) there were 5 girls treated in St. Petersburg Oncocenter, with sacrococcygeal GCT first diagnosed at older age (10 months 2 years 9 months). They all had less favorite course and prognosis (histologic variants being yolk sac tumor or embryonic carcinoma; having remote metastases in 2 cases, with relapse in 1 case, and lethal outcomes in 2 cases). Conclusion. Small-sized sacrococcygeal GCT in newborns can bear a significant risk of delayed diagnosis with possible further malignization and formation of metastases, so active revealing and active surgical treatment in such cases is needed.