ABSTRACT
Sacrococcygeal teratoma (SCT) occurs in 1 of 40 000 livebirths.45 The natural history of prenatally diagnosed SCT is very different from neonatal SCT. The well-established prognostic indicators found for neonatal SCT do not apply when SCT is detected in the fetus.46 Malignant invasion, the primary cause of death in neonatal SCT, is rare in utero.47 The physiological consequences of fetal SCT are associated with the development of high-output cardiac failure due to a ‘vascular steal’ phenomenon through solid, highly vascular tumors.48 Only 10% of fetal SCT causes hydrops and, if untreated, results in 100% mortality.49 Furthermore, SCT may lead to a potentially devastating maternal complication called maternal mirror syndrome (Ballantine syndrome).50 In this syndrome, the mother experiences progressive symptoms suggestive of pre-eclampsia, including vomiting, hypertension, peripheral edema, proteinuria, and pulmonary edema due to the release of placental vasoactive factors or endothelial cell toxins from the edematous placenta. This syndrome is reversed only by delivering the child and the placenta, but not by removing the SCT prenatally.
