Sacrococcygeal Teratomas in Children and Adolescents – A Danish 26-Year Retrospective Cohort Study

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OBJECTIVE: To describe the incidence and assess the outcome and risk of long-term sequelae of sacrococcygeal teratomas (SCTs) in children and adolescents in Denmark. STUDY DESIGN: A nationwide retrospective register-based cohort study of all Danish children aged under 18 years diagnosed with SCT (1995-2021), combining four national registries. RESULTS: We identified sixty-two patients with a female to male ratio of 4.6:1. The median age at diagnosis was 18 days (range 0 days-17 years). The incidence of SCT was 1 out of 27,513 live births, with a prenatal detection rate of 44 %. The tumors consisted of mature tissue in 48 % of the cases, 34 % contained immature tissue, and 18 % had malignant tumors. Associated anomalies were present in 16 % of the cases. At the last follow-up (median 7.3 years), 24 % of the patients experienced urological sequelae, 22 % experienced anorectal sequelae, and 4 % experienced chronic pain. Ten recurrences occurred (16 %) during the study period, with a median time to recurrence of 1.76 years (range 0.27-6.56 years) from diagnosis. Five recurrences originated from mature teratomas, four from immature teratomas, and one from a malignant teratoma. The overall SCT-related mortality was 3 %. One mortality occurred in a premature child due to intraoperative complications and one occurred in a patient with a progressive malignant metastatic SCT. CONCLUSION: The incidence of SCTs remained stable throughout the study period. We found a recurrence rate of 16 % and an SCT related mortality of 3 %. At last follow-up, one in four children experienced urological and/or anorectal sequelae.

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