Rare extracranial germ cell tumour containing tissues derived from two or more primitive germ cells.
M/C fetal neoplasm
Malignant transformation: 1–2%
Female to male ratio: 4:1
Classification
Altman classification (according to position):
Type I: External mass + small presacral component
Type II: External mass + intrapelvic component
Type III: External mass + pelvic & abdominal component
Type IV: Internal mass (intrapelvic & abdominal location)
Types II & III usually dumb-bell shaped
Pathophysiology
Abnormal migration of primordial germ cells
Persistence of primitive streak
Clinical presentation
Mass effect on the adjacent organs → Obstructive symptoms
Disfigurement and discomfort
Painful skin excoriation and ulcers
(A): Standing view showing the mass extending down the natal cleft (B): left lateral position showing a huge mass over the lower back and upper buttocks with skin excoriations. | Shatnawi, N. J., Khammash, M. R., & Omari, A. H. (2019). A giant sacrococcygeal teratoma in adult female: A case report. International Journal of Surgery Case Reports, 54, 47–50. https://doi.org/10.1016/j.ijscr.2018.11.039
Diagnosis
MRI:
(A): MRI of the pelvis showing cyst filled with faint calcifications with clear margins except over the lower coccyx compressing the pelvic structures anteriorly and superiorly. (B): MRI showing dimensions of the cyst and relations with pelvic structures. | Shatnawi, N. J., Khammash, M. R., & Omari, A. H. (2019). A giant sacrococcygeal teratoma in adult female: A case report. International Journal of Surgery Case Reports, 54, 47–50. https://doi.org/10.1016/j.ijscr.2018.11.039
