Sacrococcygeal teratoma

Find a fetal care specialist

If your baby develops a spinal tumor during your pregnancy, the experienced surgeons at our Center for Fetal Care provide the care you need. We help you safely carry and deliver your baby, with surgery to remove the sacrococcygeal teratoma during pregnancy or after birth. Throughout your baby's sacrococcygeal teratoma care, we bring together the experts and teratoma specialists you need from across Advocate Children’s Hospital.

Learn more about what to expect when you come to us for your baby’s sacrococcygeal teratoma care.

What is a sacrococcygeal teratoma?

A sacrococcygeal teratoma (SCT) is a tumor that develops during early pregnancy at the base of a baby’s spine. Although SCTs are usually benign (not cancerous), they can still grow very large and cause problems. SCTs can grow outside or inside the baby’s body or in a combination with inside and outside components.

SCTs usually contain various amounts of both solid tissue and cysts (fluid-filled sacs). Tumors that have more cysts typically grow slowly and are easier to remove. Tumors with more solid tissue can take blood away from your growing baby and cause their heart to work harder than normal.

What causes a sacrococcygeal teratoma?

The causes of sacrococcygeal teratomas are unknown. SCTs are germ cell tumors, meaning they grow from cells that form the reproductive organs.

Sacrococcygeal teratoma symptoms and signs

The signs and symptoms of SCT vary depending on the tumor’s size and location. Doctors usually identify SCTs during a routine ultrasound in pregnancy. Related signs of sacrococcygeal teratoma in the mother include:

Abnormally large uterus, usually due to excess amniotic fluid (liquid surrounding your baby in a protective membrane)
High levels of alpha-fetoprotein in a blood test

Sacrococcygeal teratoma diagnosis

If we suspect an SCT based on a routine ultrasound or blood test, we perform additional tests to confirm a diagnosis and gather information. We use imaging such as:

Targeted fetal ultrasound to more closely examine the spine and tumor
Fetal Doppler ultrasound to assess blood flow to the tumor
Ultrafast fetal MRI to measure the tumor and determine its makeup
Fetal echocardiogram (heart ultrasound) to check for heart problems

We also refer you to our genetics program for a consultation and evaluation.

Sacrococcygeal teratoma treatment

Treatment options vary depending on the tumor’s size and how it’s affecting you and your baby. If the tumor is small and your baby’s heart is healthy, our teratoma specialists usually wait until after delivery to remove the tumor.

We follow you both with imaging during pregnancy to check the tumor’s growth and watch for any complications. We watch your baby’s heart function carefully because signs of the heart working too hard may mean an earlier delivery than anticipated.

With large SCTs, hydrops fetalis may develop and cause your baby to need treatment before delivery. Our fetal surgeons and teratoma specialists have expertise in open surgery to remove SCTs. They can also use minimally invasive ablation to seal blood vessels that feed SCTs.

We can provide fetal blood transfusions if your baby develops fetal anemia. If you develop excessive amniotic fluid (the fluid that surrounds your baby during pregnancy) we can perform an amnioreduction. This minimally invasive procedure removes excess fluid to relieve pressure in the uterus and improve blood flow.

Learn more about fetal surgery at Advocate Children’s.

It’s possible to deliver your baby vaginally if the SCT is small. A cesarean section is an option if the tumor seems like it could rupture and bleed.

With large SCTs, we recommend C-sections because of the rupture risk. Our surgeons perform a special procedure called EXIT (ex utero intrapartum treatment). It involves evaluating the SCT while the baby is still attached to the placenta. The surgeons decide whether to remove the SCT immediately or wait and take it out later, when the baby is breathing and eating well.

Whether your baby has surgery at delivery or a later time, we remove the tumor completely to reduce the risk of the tumor coming back.

After surgery, our pediatric specialists provide ongoing care to prevent complications. We help manage any difficulties with bladder or bowel function, for example. Our teratoma specialists also monitor your child for several years in case the tumor returns, using physical exams, blood tests and imaging. Find out more about our treatment and services.