Sacrococcygeal germ cell tumors in childhood: an updated experience with 118 patients.

The histopathology of 118 sacrococcygeal germ cell tumors (SGCT) was correlated with clinical presentation, therapeutic management, and prognosis. There were 97 teratomas (78 mature, 19 immature), 19 embryonal, and 2 anaplastic carcinomas. Mature and immature teratomas usually presented externally (AAP type I) permitting relatively early detection and surgical removal. The immature group was significantly larger (11.6 cm vs. 7.5 cm) with a greater incidence of subsequent embryonal carcinoma (16%). The embryonal and anaplastic carcinomas were diagnosed at a later age (average 21 mo) and had a substantial presacral or endopelvic component (AAP types II-IV); this group had the worst prognosis with no survivors. Our data suggest that combined analysis of clinical findings and histopathology may help to identify some of the children at risk for early recurrence.