Type IV sacrococcygeal teratoma causing urinary retention: a rare presentation

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Abstract

Sacrococcygeal teratoma is a rare fetal neoplasm usually diagnosed antenatally and considered benign with no functional impairment. Nevertheless, fetuses with this malformation are at risk of significant perinatal morbidity and mortality, usually implying a malignant component. Management is primarily surgical, with a generally good prognosis. Herein, the authors present a rare and unusual presentation of a type IV sacrococcygeal teratoma as urinary retention in a 7-day-old infant. The diagnostic workup and subsequent surgical treatment are described. The nature of the tumor and the treatment is discussed, emphasizing the need for urgent surgical treatment because of bilateral hydronephrosis that failed to resolve after inserting a urinary catheter.

Section snippets

Case report

A 7-day-old female infant was admitted to the emergency room of a rural hospital in northern Israel, because of restlessness, abdominal swelling, and urinary retention lasting 24 hours. The parents reported a normal pregnancy and delivery at 39 weeks of gestation. The infant had no gastrointestinal signs and symptoms, and fed and behaved normally during the first week of her life. On physical examination, a big abdominal mass was palpated without peritoneal signs. The examination was otherwise

Discussion

Sacrococcygeal teratoma is the most common neonatal neoplasm. It is composed of a wide diversity of tissues foreign to the region and is believed to originate from embryological pluripotent cells during embryogenesis. The tumor is found predominantly in females and is usually discovered immediately after birth or upon antenatal sonography. Sacrococcygeal teratoma is classified according to its anatomical location and extension, following the nomenclature established by the American Academy of

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