Board MCQ Bank

Neonates with large sacrococcygeal teratomas may require intensive care specifically because they are at high risk for hemorrhage, high-output cardiac failure, tumor rupture, and disseminated intravascular coagulation (DIC). Dystocia during vaginal delivery often exacerbates tumor rupture and bleeding.

Functional results post-SCT excision often highlight fecal and urinary continence problems (soiling, constipation, urinary incontinence). These can occur due to associated urologic/anorectal anomalies, the need for reoperation, or damage to pelvic nerves/musculature, even after excision of purely extrapelvic benign tumors.

Patients who have undergone resection of sacrococcygeal teratomas must be monitored closely with physical exams (including rectal exams) and serum markers, specifically alpha-fetoprotein (AFP) and CA 125, every 2 or 3 months for at least 3 years to catch recurrences. CA 19-9 is explicitly noted as not being of value.

In screening family members for the Currarino triad, normal plain radiographs of the sacrum are not adequate because a presacral mass may exist without a bony defect. A digital rectal examination is essential and can quickly identify a presacral mass in a patient presenting with constipation.

Fetuses with a sacrococcygeal teratoma larger than 5 cm or larger than the fetal biparietal diameter should be delivered by cesarean section. Vaginal delivery with a large tumor is associated with dystocia, tumor rupture, and severe hemorrhage.