Long-Term Outcomes of Sacrococcygeal Germ Cell Tumors in Infancy and Childhood

Abstract EN

Purpose.

The aim of this study was to evaluate long-term outcomes of sacrococcygeal germ cell tumors (SC-GCTs) over a 15-year period.

Materials and Methods.

A retrospective review was conducted of all pediatric patients treated for SC-GCTs at our hospital from 1998 to 2012.

Results.

Fifty-seven patients were treated for SC-GCTs with the most common in Altman’s classification type I.

Age at surgery ranged from one day to 5.6 years.

Tumor resection and coccygectomy were primarily performed in about 84% of the cases.

Pathology revealed mature, immature, malignant sacrococcygeal teratomas (SCTs), and endodermal sinus tumors (ESTs) in 41 (72%), 4 (77%), 6 (10.5%), and 6 (10.5%), respectively.

Recurrence of discase occurred in 3 of 41 patients with mature teratomas (7.3%); 2 recurrences with mature teratomas and one recurrence with EST.

Five of 6 malignant SCTs and 3 of 6 ESTs responded well to the treatment.

Alpha-fetoprotein (AFP) level was elevated in both malignant teratomas and ESTs.

No immediate patient death was noted in any of the 57 cases, but 4 patients with malignant tumors and distant metastasis succumbed at home within 2 years of the initial treatment.

Conclusion.

Benign SCTs have a significant recurrence rate of approximately 7%.

Close follow-up with serial AFP level monitoring should be done for 5 years after initial tumor resection and coccygectomy.

The survival rate for malignant SC-GCTs with distant metastasis was unfavorable in the present study.