Preoperative selective embolization with vascular coiling of giant sacrococcygeal teratoma

Article type: Case Report

Authors: Stavropoulou, D.^{a; *} | Hentschel, R.^a | Rädecke, J.^b | Kunze, M.^c | Niemeyer, C.^d | Uhl, M.^e | Grohmann, J.^f

Affiliations: [a] Department of General Pediatrics, Adolescent Medicine, Division of Neonatology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany | [b] Department of Pediatric Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany | [c] Department of Obstetrics and Gynecology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany | [d] Department of Pediatric Hematology and Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany | [e] Department of Radiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany | [f] Department of Congenital Heart Defects and Pediatric Cardiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany

Correspondence: [*] Address for correspondence: Dimitra Stavropoulou, Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center– University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. E-mail: [email protected].

Abstract: Sacrococcygeal teratoma is one of the most common congenital tumors. Its optimal management requires interdisciplinary care by obstetricians, radiologists, pediatric surgeons, and neonatologists. Early surgery entailing complete tumor excision is the main therapy aim, but a substantial risk of life-threatening complications remains, especially uncontrollable intraoperative hemorrhage. To reduce the risk of bleeding in a female neonate with a giant sacrococcygeal teratoma, we successfully coil-embolized the tumor’s main feeding arteries. Her subsequent complete surgical resection was uneventful, and the child is well with favorable reconstructive and functional status of all involved and adjacent organ systems.

Keywords: Sacrococcygeal teratoma, coil embolization, sacral artery, iliac artery, neonate, transcarotid access, Penumbra occlusion device

DOI: 10.3233/NPM-180066

Journal: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 3, pp. 345-349, 2019