Differentiating presacral masses in anorectal malformations and isolated sacrococcygeal teratomas

Pediatr Surg Int. 2019 Sep;35(9):979-983. doi: 10.1007/s00383-019-04510-4. Epub 2019 Jun 29.


Purpose: Presacral masses associated with anorectal malformations (ARM) are most frequently dermoid or teratomas. Sacrococcygeal teratoma (SCT), in isolation, is a different condition. There are limited data comparing the two. The aim of this study was to compare presacral masses associated with ARM and isolated SCTs.

Methods: A retrospective review was performed from 1979 to 2018. Patients with presacral masses and associated ARM (n = 39) were identified and compared to patients with isolated SCTs (n = 32).

Results: Those with presacral mass and ARM had a lower proportion of immature and mixed teratomas by pathology and a longer time to mass resection. They had higher percentages of sacral anomalies (76% versus 9%), tethered cord (50% versus 6%), and other anomalies (51% versus 9%). For long-term bowel function, patients with presacral mass and ARM were more likely to be fecally incontinent and require enemas (59% versus 11%). Regarding isolated SCTs, 4% recurred with a time to recurrence of 7 months.

Conclusions: Compared to patients with isolated SCT, patients with presacral mass and ARM had lower grade tumors. In addition, they had a higher proportion of sacral defects and other congenital defects, as well as worse bowel function outcomes.

Keywords: Anorectal malformation; Bowel function outcomes; Presacral mass; Sacrococcygeal teratoma.

MeSH terms

  • Anorectal Malformations / complications*
  • Anorectal Malformations / diagnosis
  • Anorectal Malformations / pathology*
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Humans
  • Infant
  • Male
  • Retrospective Studies
  • Sacrococcygeal Region / surgery
  • Soft Tissue Neoplasms / complications*
  • Soft Tissue Neoplasms / diagnosis
  • Soft Tissue Neoplasms / pathology*
  • Teratoma / complications*
  • Teratoma / diagnosis
  • Teratoma / pathology*