Sacrococcygeal Teratoma (SCT)

Our long experience with prenatal diagnosis and planning for optimum care allows us to offer the highest quality treatment whether intervention is indicated before or after birth.

Under the direction of Dr. Michael Harrison, the Fetal Treatment Center was the first institution to develop fetal surgery techniques. The first open fetal surgery in the world was performed at UCSF since the early 1980's. We presently have more experience with fetal surgery and endoscopic fetal intervention (FETENDO fetal surgery) than any other institution in the world. We are dedicated to Sacrococcygeal teratoma research and treatment innovation.

What is Sacrococcygeal Teratoma (SCT)?

Sacrococcygeal teratoma (SCT) is an unusual tumor, occuring in about 1:40,000 live births. The tumor is located at the base of the tailbone (coccyx) of the newborn. This birth defect is more common in female than in male babies. Although the tumors can grow very large, they are usually not malignant (that is, cancerous). They can usually be cured by surgery after birth, but occasionally cause trouble before birth.

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What is the outcome for a fetus with Sacrococcygeal Teratoma?

Most fetuses with sacrococcygeal teratoma do well with surgical treatment after birth. These tumors are generally not malignant. Babies with small tumors that can be removed along with the coccyx bone after birth can be expected to live normal lives. They will need to be born in a hospital with pediatric surgeons and a specialized nursery. After hospital discharge, it is our practice to follow children who have had an SCT resection closely. We recommedn oncology and pediatric surgeon followup with bloodtesting of alpha-fetoprotein (AFP) during early childhood.

Fetuses with larger tumors or tumors that go up inside the baby’s abdomen will require more complex surgery after birth, but in general do well. Again, they will have to be followed with blood tests for several years. Fetuses with very large tumors, which can reach the size of the fetus itself, can pose a difficult problem both before and after birth.

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How serious is my fetus’s Sacrococcygeal Teratoma?

In order to determine the severity of your fetus's condition it is important to gather information from a variety of tests and determine if there are any additional problems. These tests along with expert guidance are important for you to make the best decision about the proper treatment.

This includes:

1. The type of defect—distinguishing it from other similar appearing problems.
2. The severity of the defect—is your fetus’s defect mild or severe.
3. Associated defects—is there another problem or a cluster of problems (syndrome).

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What are my choices during this pregnancy?

Most newborns with SCT survive and do well. Malignant tumors are unusual. Fetuses with large cystic SCTs rarely develop hydrops and therefore are rarely candidates for fetal intervention. These cases are best handled with surgical removal of the tumor after delivery. A Cesarean-section delivery of the baby may be necessary if the tumor is larger than 10 cm (4 inches).

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What will happen after birth?

All babies with SCT should be delivered at a specialized hospital with pediatric surgery expertise. Tumors larger than 10 cm in diameter will require C-section delivery. The neonatologist will provide support in the intensive care nursery until the baby is stable enough for surgery.

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