A newborn girl has a large external sacrococcygeal mass covered by intact skin, with a normal anus anteriorly. MRI shows the mass is almost entirely external. Alpha-fetoprotein is markedly elevated. Which statement is correct?

• A Most malignant variants are yolk sac tumours arising in the solid component
• B Elevated AFP rules out benignity and mandates biopsy before resection
• C Recurrence is prevented by leaving the coccyx to preserve pelvic support
• D Complete resection requires removal of the coccyx ✓

Explanation

Sacrococcygeal teratoma is the most common neonatal tumour, and complete excision must include the coccyx because it contains the terminal branches of the tumour's vascular supply and residual rests there drive recurrence rates above 30 percent if left behind. AFP is physiologically very high in neonates and does not itself prove malignancy. Malignant transformation, most often yolk sac tumour, rises steeply after 2 months of age, reinforcing early resection.

Reference: Ashcraft's Pediatric Surgery, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.