Sacrococcygeal teratoma, marker is –
Correct Answer: b-HCG
Description: Ans. is 'b' i.e., bHCG Sacrococcygeal teratoma o A sacrococcygeal teratoma (SCT) refers to a teratoma arising in the sacrococcygeal region. The coccyx is almost always involved. Demographics and clinical presentation o It is the commonest congenital tumour in the fetus and neonate. The incidence is estimated at ~ 1 : 35000 - 40000. There is recognized female predilection with a M : F ratio of l : 4. The sacrococcygeal region is also the commonest location for non-CNS teratomas. Pathology o They are thought to arise from totipotent cells from the node of Hensen 1,3 at the anterior aspect of the coccyx by about the 2nd to 3rd weeks of gestation. There are most often mixed solid/cystic, although purely cystic types can occur in ~ 15% of cases. o The tumour is composed of the all three germ cells (i.e. ectoderm, mesoderm and endoderm) Genetics Most cases tend to be sporadic Associations Myelomeningocele Vertebral anomalies Markers Can have elevated levels of o alpha feto protein (AFP) * o beta HCG Classification A pathology-based classification is as: Benign (mature) : much more common comprising ~ 60 - 70% Malignant (immature) A location based classification system according to the American Academy of Pediatric Surgery Section Survey is: Type I: developing only outside the fetus (can have small presacral component) / accounts for the majority of cases : 47%. Type II: Extra-fetal with intra-pelvic pre-sacral extension. Type III: Extra-fetal with abdomino-pelvic extension. Type IV : Tumour developing completely in the fetal pelvis.
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