A rare observation of simultaneous removal of a giant sacrococcygeal teratoma, with massive presacral and external components, and preoperative endovascular occlusion of the feeding arteries of the tumor, in a newborn
Authors:   Center for neonatal surgery for malformations and their rehabilitation of SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine», Kyiv, Ukraine, Sliepov O.K. , Perederii O.V. ,   Center for neonatal surgery for malformations and their rehabilitation of SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine», Kyiv, Ukraine, Grebinichenko G.O. ,   SI Institute of Pediatrics of Obstetrics and Gynecology named after academician O.М. Lukyanova of the NAMS of Ukraine, Kyiv, Skrypchenko N.Y. ,   SI Institute of Pediatrics of Obstetrics and Gynecology named after academician O.М. Lukyanova of the NAMS of Ukraine, Kyiv, Ditkivskyy I.O. ,   National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine, Kyiv, Ukraine, Tammo Raad ,   SI "Scientific and Practical Medical Center for Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine", Kyiv, Deinega M.I. ,   SI Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine, Kyiv
Published: September 2024

Aim - to analyze and describe the experience of a one-moment removal of a giant sacrococcygeal teratoma (SCT), with massive presacral and external components (III type), and preoperative endovascular occlusion of the feeding arteries of the tumor, in a newborn, based on a clinical case. Clinical case. A unique clinical case of a giant SCT with massive presacral and external components and preoperative endovascular occlusion of the feeding arteries of the tumor in a newborn is presented. Features of perinatal support, preoperative endovascular occlusion of the feeding arteries of the SCT and surgical intervention are described, which are important elements of optimizing the treatment of children with this life-threatening pathology. Conclusions. In the diagnosis and treatment of SCT, a scientifically based, differentiated approach is necessary, which includes: early (up to 22 weeks of gestation) complex prenatal diagnosis for choosing rational tactics of pregnancy management, examination of the fetus, delivery by cesarean section, postnatal diagnosis, preoperative preparation and surgical treatment. The first described preoperative endovascular occlusion of the feeding arteries of the presacral and external components of the SCT provides tumor devascularization and minimization of intraoperative blood loss during one-moment resection of a highly vascularized giant tumor. Adequate assessment and rational conservative treatment of a severe complication of the early postoperative period - thrombosis of the infrarenal section of the aorta made it possible to eliminate the life-threatening complication and achieve complete recanalization of the thrombosed section of the aorta and restore full blood flow in the lower extremities. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting studies. No conflict of interests was declared by the authors.