Clinicopathological Profile of Sacrococcygeal Teratomas: A Retrospective Observational Study from North India

Introduction: Sacrococcygeal Teratomas (SCTs) are the most common extragonadal germ cell tumours during the neonatal period. Although they are typically benign, these tumours carry a significant risk of malignant transformation if not treated promptly. Early diagnosis through clinical evaluation, laboratory tests, and radiological investigations, followed by surgical excision, is crucial in preventing malignancy and ensuring better outcomes. Aim: To comprehensively analyse SCTs by examining the demographic distribution, clinical features, radiological characteristics, and histopathological profiles of affected patients. Materials and Methods: This retrospective descriptive observational study was conducted in the Department of Paediatric Surgery of Pandit Bhagwat Dayal Sharma, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India, from June 2018 to May 2022 involving 11 patients diagnosed with SCT. These patients underwent thorough clinical evaluations, laboratory investigations, and radiological assessments. All patients were treated using standard posterior surgical excision techniques. Postoperative follow-up included both short- and long-term monitoring, focusing on wound infections, recurrence, and metastasis. The data were analysed using Statistical Packages for Social Sciences (SPSS) software version 25.0. Continuous variables were presented as mean±Standard Deviation (SD) or median and range, depending on the distribution. Categorical variables were expressed as frequencies and percentages. Results: Out of 11 patients, there were nine females and two males. The median age at presentation was 18 days, ranging from one day to three years. The majority of tumours belonged to Altman type 1a7 (63.6%), while types 2 and 3 each constituted two cases (18.2%). Clinical presentation predominantly involved a lower back mass Since birth in 10 (90.9%) cases. Histopathological Examination (HPE) revealed mature teratomas in 9 (81.8%) cases, with immature teratoma and yolk sac tumour each accounting for 9.1% (1 case each). Notably, early presentations correlated with mature teratomas, whereas delayed presentations were associated with yolk sac tumours. One patient with a Type 3 lesion experienced recurrence and metastasis during the follow-up period. Conclusion: The SCTs are predominantly found in neonates, with a strong female predominance. Early detection generally results in a favourable outcome, while delayed diagnosis is associated with an increased risk of malignancy, recurrence, and poorer prognosis. Careful follow-up is essential, particularly for patients with higher-risk tumour types and later-stage presentations.