Percutaneous laser ablation of sacrococcygeal teratoma in a hydropic fetus with severe heart failure - Too late for a surgical procedure?

Rodrigo Ruano, Sergio Duarte, Marcelo Zugaib

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Sacrococcygeal teratoma (SCT) is the commonest solid fetal tumor. Perinatal prognosis is usually favorable, but sometimes it can be complicated by fetal hydrops being responsible for high risk of mortality. Fetal therapy in such cases has so far not been established. We report a case with a giant solid SCT associated with fetal hydrops and severe heart failure. 2D- and 3D-Doppler ultrasonography revealed great vessels originated from the medial sacral artery. Percutaneous laser ablation of these vessels was performed at 24 weeks of gestation. During the procedure, severe anemia was also diagnosed (hemoglobin 4.3 g/dl). Two days later, the fetus died and pathological examination revealed local tumor necrosis and blood hemorrhage inside the mass. We suggest that in such cases, fetal surgery may not be enough, being too late, and perhaps fetal clinical therapy for anemia and heart failure could be the best option at a gestational age of less than 28 weeks.

Original languageEnglish (US)
Pages (from-to)26-30
Number of pages5
JournalFetal Diagnosis and Therapy
Volume25
Issue number1
DOIs
StatePublished - Aug 1 2009

Keywords

  • Color Doppler ultrasonography
  • Fetal surgery
  • Laser
  • Prenatal diagnosis
  • Sacrococcygeal teratoma
  • Ultrasonography

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Embryology
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

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