Sacrococcygeal teratoma in children: current perspectives on the pathology and results of our own observations

Abstract

Background. Sacrococcygeal teratoma is a relatively rare and clinically important tumor of childhood, mainly considered in the context of pediatric surgery, neonatology, and pediatric oncology due to its potential malignancy, high incidence of complications, and peculiarities of the postoperative course. Purpose – to analyze our own observations and modern scientific data published in the period from 1993 to 2025 regarding the clinical and epidemiological features, frequency, age and gender characteristics, histological structure, risk factors, diagnostic methods, treatment and prognosis of sacrococcygeal teratomas in children. Materials and methods.This study is a review and is based on a systematic analysis of scientific publications published between 1993 and 2025, selected from authoritative sources of international medical databases, including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar. Results. In Sweden, the incidence of sacrococcygeal teratoma is 7.1 cases per 100,000 live births, in Finland it is 9.3 per 100,000, while in Japan and Korea it is 1 to 2 cases per 40,000. In Central European countries, such as the Czech Republic, the incidence is higher, partly due to the high quality of prenatal diagnosis – more than 77% of cases are identified before birth. In most of the studied cohorts, there is a clear female predominance, with a proportion of 70% to 75%, indicating a high sex ratio. It was found that the ratio of tumor volume to body weight over 27.4 and the ratio of tumor length to child height over 28.2 correlate with the likelihood of repeated surgical intervention, while the ratio of tumor volume to body weight over 2.7 indicates an increased risk of perioperative complications. The data obtained in our own study demonstrate a typical epidemiological structure of sacrococcygeal teratoma, with a clear predominance among girls and an early age of manifestation. The patient profile and treatment approaches indicate timely hospitalization and timely surgical intervention, which reduces the risk of progression and development of complications. Conclusions. Sacral-coccygeal teratomas in children remain a rare but clinically significant pathology that requires early diagnosis, prenatal monitoring and multidisciplinary treatment taking into account individual prognosis. The results of the analysis of scientific literature for 1993–2025 showed that prenatal diagnosis in combination with the use of prognostic parameters of the ratio of tumor length to child height allows for timely assessment of risks and reduce the incidence of severe complications. It was determined that histological immaturity of the tumor, its large extent,high vascularity, type IV according to the Altman classification, incomplete resection and intraoperative spillage are leading risk factors for recurrence and reduced survival.