Sacrococcygeal Teratoma: Rare Tumors In Children that Grow Hair and Teeth

A teratoma is a type of rare congenital tumor. It is seen predominantly in girls with a ratio of four females to one male. It is the most common tumor of the newborn with an incidence of 1 in 40,000 live births. They also occur more frequently in twins or in families where there is a history of twins. The name teratoma in Greek means "monster tumor". In the newborn, the most common congenital tumor is a sacrococcygeal (tail bone) tumor. Since the tumor is often visible from the outside of the body, diagnosis is made immediately and treatment and/or surgery are initiated early, making the prognosis for this type of tumor very favorable.

Sometimes this treatment begins even before a baby is born. When diagnosed early in gestation and when the tumor is very large, it may result in birth defects or fetal death. When the tumor occurs later in pregnancy, fetal intervention is used to remove most of the tumor and Cesarean delivery usually is needed. These large tumors can be both benign and malignant.

A teratoma often contains tissues which are quite different from the tissues in the surrounding area. What is so interesting about a teratoma is that it has been known to grow hair and teeth. Some teratomas may contain a mixture of well-differentiated, mature tissues such as: Respiratory epithelium, hair follicles, fat tissue, mature nervous tissue, bones, brain tissue, skin, lung tissue and tissues from the gastrointestinal tract. It may also contain fingers, teeth, jawbone, and skeletons. Some teratomas secrete thyroxin and in some cases in such a large degree that it can lead to clinical hyperthyroidism in the patient.

Because of the ethical issues surrounding the source of human stem cells, teratomas are being considered as an alternative source for research since they lack the potential to grow into functional human beings.

The cure rate of benign sacrococcygeal teratoma is over 90%. The cure rate of malignant teratoma is near zero. All sacrococcygeal masses should be excised before the child is four months old. If the tumor proves to be a teratoma, the whole tumor mass and entire coccyx must be removed.

Treatment of teratoma consists of surgical removal. The procedure can be quite delicate due to the close proximity to important anatomic structures. Even with removal, occasional recurrence is to be expected, especially when portions of the teratoma must be left in place to preserve normal anatomic structures. Long-term careful follow-up is needed.