Abstract
Sacrococcygeal teratoma (SCT) is an unusual tumor in adults. The incidence of malignant transformation of this tumor increases when its excision is delayed beyond 1 month of age. We report an uncommon case of adenocarcinoma arising within the colonic mucosa of a mature teratoma of the sacrococcyx in a 44-year-old male. The patient received surgical resection for a sacrococcygeal mass in a local hospital and was diagnosed with adenocarcinoma arising from SCT. He was referred to our hospital for further treatment and received chemotherapy as adjuvant treatment. After 4.5 years, the coccygeal mass recurred on follow-up imaging workup, and surgical resection was performed. On pathologic work-up, residual disease at the resection margin was identified microscopically. Pathologic diagnosis was a primary adenocarcinoma arising from the colonic mucosa within a mature teratoma. The patient received adjuvant-chemotherapy and radiotherapy and has been followed up.
천미부 기형종이 성인에서 발견된 경우 반드시 즉시 절제술이 시행되어야 하며 수술적 절제 가장자리가 충분히 확보되어야 하고 악성화 전환의 위험성 때문에 종양이 분열되지 않게 주의하여야 한다. 현재 보고되어 있는 많지 않은 증례와 본 증례를 비교하였을 때, 기형종 안의 선암으로의 변환된 환자에서 반드시 다학제적인 접근이 요구되며 수술 단독치료는 불충분하고 적극적인 보조 항암 치료 및 방사선 치료가 고려되어야 한다.