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 Table of Contents  
Year : 2018  |  Volume : 7  |  Issue : 2  |  Page : 20-21

Sacrococcygeal teratoma showing pigmented epithelium: A case report

Department of Pediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India

Date of Submission29-Mar-2018
Date of Acceptance11-Oct-2021
Date of Web Publication14-Mar-2022

Correspondence Address:
Aditya P Singh
Near The Mali Hostel, Main Bali Road, Falna, Dist. Pali, Rajasthan.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijhi.IJHI_2_18

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Teratoma may comprise either well-differentiated or primitive tissue. The tumor is diagnosed as an immature teratoma if there are areas of immature tissue in the stromal, epithelial, or neural component. The ectodermal components typically include squamous epithelium and neural tissue. We are presenting here a case of sacrococcygeal teratoma with pigmented epithelium on histopathology in a newborn female child.

Keywords: Immature, pigmented epithelium, teratoma

How to cite this article:
Singh AP, Gupta AK, Ansari M, Tanger R, Barolia DK. Sacrococcygeal teratoma showing pigmented epithelium: A case report. Int J Histopathol Interpret 2018;7:20-1

How to cite this URL:
Singh AP, Gupta AK, Ansari M, Tanger R, Barolia DK. Sacrococcygeal teratoma showing pigmented epithelium: A case report. Int J Histopathol Interpret [serial online] 2018 [cited 2023 Sep 29];7:20-1. Available from: https://www.ijhi.org/text.asp?2018/7/2/20/339626

  Introduction Top

Teratoma has an embryonic origin and it is composed of various tissues derived from three germ layers (ectoderm, endoderm, and mesoderm).[1] The histological findings are graded as follows: Grade 0, tumor contains only mature tissue; Grade 1, tumor contains rare foci of immature tissues; Grade 2, tumor contains moderate quantities of immature tissues; Grade 3, tumor contains large quantities of immature tissue with or without malignant yolk sac elements.[2] The present case was diagnosed as Type I and Grade 3 according to the AAPSS classification. We are reporting here a case of sacrococcygeal teratoma with pigmented epithelium on histology.

  Case Report Top

The parent of a newborn female child presented to us with the complaint of swelling in a sacrococcygeal region since birth. Swelling was around 2×1 cm in size and pedunculated. It was covered with skin. Anus was normally placed. The baby was born via normal vaginal delivery. Antenatal ultrasound was normal. Routine blood investigations were within normal limits including complete blood counts, renal function test, liver function test, and serum electrolytes. Tumor markers were also within normal limits including beta-human chorionic gonadotropin and alpha-fetoprotein. Contrast-enhanced computed tomography showed a heterogeneous density lesion of size 17×16 mm with mixed solid and cystic component in the sacrococcygeal region extending to the subcutaneous tissue [Figure 1]. There was no extension seen in pelvis. It was suggestive of sacrococcygeal teratoma. We excised it completely and sent for histopathological examination. Histopathological examination revealed type 3 immature teratoma with cartilage, primitive neuroepithelium with pigmented epithelium, and mature neuroglial tissue with oligodendroglial cells [Figure 2].
Figure 1: CECT image

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Figure 2: Histopathology image showing pigmented epithelium

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  Discussion Top

The incidence of sacrococcygeal teratoma is between 1/35,000 and 1/40,000 live births and has a 4:1 female: male ratio.[3] It can be diagnosed with antenatal abdominal ultrasonography, which is treated with surgical resection following birth.[4] The prognosis depends on the extent and histological scoring of the tumor. It has an excellent prognosis if the tumor has no immature components and adequate resection is performed.[3] Teratomas with a retina-like structure have been reported, and some of the cases showed a complete or partial eye structure.[5],[6]

  Conclusion Top

It is a very rare case of sacrococcygeal teratoma with pigmented epithelium on the histology. It needs more cases of such histology for further research.


Dr. Neelam Dogra, Anesthesiologist, Senior Professor, SMS Medical College, Jaipur is acknowledged.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Azizkhan RG, Caty MG. Teratomas in childhood. Curr Opin Pediatr 1996;8:287-92.  Back to cited text no. 1
Graf JL, Housely HT, Albanese CT, Adzick NS, Harrison MR. A surprising histological evolution of preterm sacrococcygeal teratoma. J Pediatr Surg 1998;33:177-9.  Back to cited text no. 2
Tuladhar R, Patole SK, Whitehall JS. Sacrococcygeal teratoma in the perinatal period. Postgrad Med J 2000;76:754-9.  Back to cited text no. 3
Winderl LM, Silverman RK. Prenatal identification of a completely cystic internal sacrococcygeal teratoma (type IV). Ultrasound Obstet Gynecol 1997;9:425-8.  Back to cited text no. 4
Sergi C, Ehemann V, Beedgen B, Linderkamp O, Otto HF. Huge fetal sacrococcygeal teratoma with a completely formed eye and intratumoral DNA ploidy heterogeneity. Pediatr Dev Pathol 1999;2:50-7.  Back to cited text no. 5
Takamatsu M, Aoki H, Hirose Y, Kobayashi K, Tomita H, Kuno T, et al. Teratoma showing the features of retinal structure: A case of sacrococcygeal teratoma. Oncol Lett 2012;3:1023-6.  Back to cited text no. 6


  [Figure 1], [Figure 2]


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