Sacrococcygeal Teratoma (SCT)
What Is a Sacrococcygeal Teratoma?
A sacrococcygeal teratoma (SCT) is a rare type of tumor that forms at the base of the spine (the sacrum and coccyx) in newborns and infants. It is the most common tumor found in newborns and is typically detected either prenatally via ultrasound or shortly after birth. SCTs are composed of various types of tissue and are usually benign (non-cancerous), although some can have malignant (cancerous) components.
Causes and Risk Factors
The exact cause of SCT is unknown, but it develops from embryonic cells that persist at the base of the spine and grow abnormally. There is no known genetic or environmental cause, and it is typically not associated with other syndromes. SCTs are more common in females than males and occur in approximately 1 in 35,000 to 40,000 live births.
Signs and Symptoms
Symptoms depend on the size and location of the tumor. Common signs include:
- A visible or palpable mass at the base of the spine
- Difficulty with bowel or bladder function
- Abdominal distention if the tumor is large and internal
- Feeding issues or respiratory distress in severe prenatal cases
In many cases, SCTs are detected during routine prenatal ultrasounds.
Diagnosis and Evaluation
Diagnosis often begins with prenatal imaging. After birth, evaluation may include:
- Physical examination of any external mass
- Ultrasound or MRI to assess the full extent of the tumor
- Blood tests including alpha-fetoprotein (AFP) levels, which can be elevated in SCTs
Treatment
Surgical removal of the tumor is the standard treatment for SCT. In almost all cases, the coccyx (tailbone) is also removed to reduce the risk of recurrence. The timing of surgery depends on the size, type, and symptoms. Some large or vascular tumors may require coordinated care between pediatric surgeons and neonatologists immediately after birth. Ongoing monitoring includes follow-up imaging and AFP testing to watch for recurrence or malignant transformation.
