[size=20px]An infant is born at 36 weeks gestation with a prenatal diagnosis of sacrococcygeal teratoma (SCT). At birth, the diagnosis of a SCT is confirmed and it has a significant abdominal component. The baby undergoes an uneventful resection of the tumor and is found to have benign pathology. What is an important component of this baby’s follow-up prior to hospital discharge?

 

A Ultrasonograpy of the hips

 

B Anal manometry

 

C Pulmonary function testing

 

D No further followup required[/size]

A

A

correct answer

A Ultrasonograpy of the hips

 

Follow up studies for babies with SCT routinely involve serial examination of alpha-fetoprotein and beta-hCG along with physical examinations to assess for recurrence. The most common anomalies associated with SCT are urologic, including hydronephrosis and vesicoureteral reflux which have been reported to be seen in as many as 35-45% of children with SCT. A recent population-based study from the Netherlands showed an incidence of hip dysplasia in infants with SCT - nearly 5%, and not related to Altman classification. These findings mirror those of other previously reported retrospective studies. Therefore, recommendations for hip ultrasonography as a followup in these infants have been put forth based upon the significant long-term disabilities associated with undiagnosed hip dysplasia. Other entities such as constipation and bowel management issues are also seen, but routine anal manometry is not recommended. Pulmonary issues are more related to prematurity rather than the tumor itself, as many of these infants are born prematurely, but routine pulmonary function testing is not recommended.