Sacrococcygeal teratoma in the fetus: possibilities of radiological examination

The article presents a clinical case illustrating the importance of a multimodal diagnostic approach in the management of a patient with a sacrococcygeal teratoma of the fetus. Sacrococcygeal teratoma is a congenital tumor that is histogenetically associated with embryonic pluripotent cells of the primordial streak (gonadal crest) in the sacrococcygeal region. This nosology is recognized as the most common in newborns, with a pronounced gender predisposition — it is diagnosed 3–4 times more often in girls than in boys. The presented clinical data demonstrate that the consistent and comprehensive use of a multimodal protocol allows not only to state the fact of the presence of teratoma, but also to obtain a multi-level characteristic of the disease. This approach allows us to: form a holistic view of the macro- and microstructure of the tumor; predict potential risks for both the fetus (development of hydrops, “robbery” syndrome) and the course of childbirth (risk of dystocia, tumor rupture); determine the optimal method and timing of delivery; and develop a clear and reasonable plan for surgical treatment of newborns. The implementation of a standardized multimodal diagnostic algorithm, including step-by-step use of ultrasound and fetal magnetic resonance imaging, in clinical protocols for managing pregnant women with suspected sacrococcygeal teratoma is crucial. As a result, the main goal is achieved: a significant improvement in perinatal outcomes for this complex group of patients.