We present a case of  Sacrococcygeal Teratoma type 4.

Our ultrasound revealed the following findings:

• Abdominal circumference was larger than expected gestational age.
• Polyhydramnios
• Image 1, Video 1-3: Bilateral pelvicalyceal dilatation, a giant  mass in the abdomen. Note the dilated umbilical arteries. Both intraabdominal umbilical arteries course more lateral than usual due to compression of the mass in the abdomen.
• Video 4-5: Predominantly solid and highly vascularized intraabdominal mass. Dilated bladder and ascites.

After preterm premature rupture of membranes, the fetus was delivered via cesarean section at 32 weeks. Physical exam revealed an abnormally distended abdomen and a birth weight of 3135 g. Radiologic examination confirmed the intraabdominal mass. The neonate underwent surgical excision 6 days after delivery. A 13 x 10 cm retroperitoneal mass originating from coccyx was excised. The pathologic diagnosis was immature teratoma grade 3. The baby expired after the operation.

References

[1] Ayed A, Tonks AM, Lander A, et. al. A review of pregnancies complicated by congenital sacrococcygeal teratoma in the West Midlands region over an 18-year period: population-based, cohort study. Prenat Diagn 2015; 35: 1037-1047.
[2] Swayze CF, Wheeler TC. "Sacrococcygeal teratoma." TheFetus.net. https://thefetus.net/content/sacrococcygeal-teratoma-3, Publish date 06/2022.
[3] Tihonenko I, Venchikova N, Nerovnya A, et al. "Case of the Week # 276." TheFetus.net. https://thefetus.net/content/case-of-the-week-276, Publish date 9/2010.