Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
The patient was a 32 week premature female born at an outside hospital who was diagnosed with a large sacral soft tissue mass at birth. The antenatal history was remarkable for polyhydramnios diagnosed via prenatal ultrasound, pregnancy induced hypertension, and removal of a maternal dermoid during pregnancy.
Clinical Physical Exam:
Large exophytic soft tissue mass in the region of the sacrum.
Images 1 and 2
Clinical Differential Diagnosis:
Babygram from the first day of life showed a huge soft tissue mass arising from the gluteal region.
Imaging Differential Diagnosis:
The patient was taken to the operating room on the second day of life. The sacral mass was excised.
Examination of the surgical specimen revealed it to be 22 x 18 x 12 cm in size and was composed of multiple cysts within it. A single soft tissue focus that resembled brain tissue was noted. No hair or teeth were seen. A microscopic foci of embryonal carcinoma and endodermal sinus tumor was noted. The findings were consistent with a diagnosis of immature teratoma.
Images 7, 8, 9, and 10
Images 12, 13, 14, and 15
Follow-up and Prognosis:
Postoperatively, the patient developed a sciatic nerve palsy and poor anal control and underwent a perineal reconstruction at 16 months of age.
Follow us on Twitter @pedseducation and @pedsimaging and Facebook @pedsimaging and Instagram @pedsimaging
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2016 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.