Sacrococcygeal Teratoma

Sacrococcygeal teratomas are generally not cancerous, and most babies do well with surgical treatment after birth. Babies with small tumors that can be removed along with the coccyx bone after birth can be expected to live normal lives. However, they will need to be delivered in a hospital with pediatric surgeons and a specialized nursery.

Fetuses with larger tumors or tumors that go up inside the baby's abdomen will require more complex surgery after birth, but generally do well. Very large tumors, which can reach the size of the fetus, can pose a difficult problem both before and after birth.

We have found that SCTs that are largely cystic — meaning filled with fluid — generally don't cause a problem. However, SCTs that are made up of mostly solid tissue and have a lot of blood flow can have adverse effects. This is because the fetus's heart has to pump blood to circulate not only to its body, but also to all the blood vessels of the tumor, which can be as big as the fetus. In essence, the heart is performing twice its normal amount of work.

Fetal echocardiography can be used to measure how hard the heart is working. If heart failure does develop — usually in cases with solid, rapidly growing tumors — the fetus usually will not survive without immediate intervention before birth.

Fetuses with large tumors that have a great deal of blood flow must be followed closely to watch for the development of heart failure, which can lead to fetal death. Even if heart failure does not develop, these babies may require caesarian section delivery and an extensive operation after birth. Most babies will do well once the tumor is completely removed.

The surgery can have long-term consequences, including the reoccurrence of the tumor or difficulty with urination. The child should undergo yearly blood tests for elevated alpha feto-protein (AFP) levels, and should be followed by an oncologist (cancer specialist) and pediatric surgeon in early childhood.

Maternal Mirror Syndrome

In cases of extreme fetal hydrops, the mother may be at risk for maternal mirror syndrome, which is when the mother's condition mimics that of the sick fetus. The mother may develop symptoms similar to pre-eclampsia, such as vomiting, hypertension, swollen feet and hands, proteinuria (protein in the urine) and fluid in the lungs. Maternal mirror syndrome may occur even if the SCT is surgically removed in utero.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Intensive Care Nursery
1975 Fourth St., Third Floor
San Francisco, CA 94158
Phone: (415) 353-1565
Fax: (415) 353-1202

Fetal Treatment Center
1855 Fourth St., Second Floor, Room A-2432
San Francisco, CA 94158
Phone: (800) 793-3887
Fax: (415) 502-0660
Appointment information

Surgery Clinic
1825 Fourth St., Fifth Floor, 5B
San Francisco, CA 94158
Phone: (415) 476-2538
Fax: (415) 476-2929
Appointment information