Preoperative embolization of giant sacrococcygeal teratoma in a premature newborn

Abstract Resection of a large vascular sacrococcygeal teratoma (SCT) in a newborn has the potential to be a fatal procedure caused by hemolysis, rupture, or bleeding of the tumor. Usually, most blood supply of an SCT is derived from the middle sacral artery. As soon as these arteries have been ligat...

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Bibliographic Details
Published in:Journal of pediatric surgery 2011, Vol.46 (1), p.e5-e8
Main Authors: Lahdes-Vasama, Tuija Terhikki, Korhonen, Päivi H, Seppänen, Janne M, Tammela, Outi K, Iber, Tarja
Format: Article
Language:English
Subjects:
Blood Loss, Surgical - prevention & control
Catheter Ablation
Embolization
Embolization, Therapeutic - methods
Female
Fetal Diseases - diagnostic imaging
Hemolysis
Hemorrhage - prevention & control
Humans
Hyperkalemia - epidemiology
Infant, Newborn
Infant, Premature
Intraoperative Complications - epidemiology
Middle sacral artery
Pediatrics
Premature newborn
Preoperative
Preoperative Care - methods
Sacrococcygeal Region - blood supply
Sacrococcygeal Region - surgery
Sacrococcygeal teratoma
Soft Tissue Neoplasms - blood supply
Soft Tissue Neoplasms - surgery
Soft Tissue Neoplasms - therapy
Surgery
Teratoma - blood supply
Teratoma - surgery
Teratoma - therapy
Ultrasonography, Prenatal
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Summary:Abstract Resection of a large vascular sacrococcygeal teratoma (SCT) in a newborn has the potential to be a fatal procedure caused by hemolysis, rupture, or bleeding of the tumor. Usually, most blood supply of an SCT is derived from the middle sacral artery. As soon as these arteries have been ligated, further blood loss is minimal. There is only one previous presentation about preoperative embolization of these arteries. We present a case in which the feeding arteries of a giant SCT were embolized in an infant born at 30 weeks and 3 days of gestation. Although bleeding during the surgery was minimal, continuous need of transfusions and life-threatening hyperkalemia created severe problems during surgery, until tumor resection was completed. This is the smallest reported patient in whom SCT was preoperatively treated by embolization.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2010.09.038