Abstract
A prenatally diagnosed sacrococcygeal teratoma was excised during the neonatal period followed by partial excision of a lumbosacral teratoma with occult bifid spine at 3 months. The residual tumor was extended posteriorly to the spinal canal and caused right lower hemiplegia and dysuria. Imaging studies revealed that the tumor in the spinal canal was extended up to the lower thoracic spine level, severely compressing the spinal cord and further extended to the retroperitoneum through bilateral intervertebral foramina. The teratoma in the spinal canal was a subdural extramedullary tumor and was totally excised through laminotomy at 9 months of age. The paravertebral retroperitoneal part of the tumor was excised through a lower midline excision and an extraperitoneal approach. The tumor capsule was the dura mater, which was so extended and thin that the repair of the dura was technically very difficult. This approach provided a satisfactory operative view and a working space and was considered suitable and safe for bilateral retroperitoneal tumor excision. The postoperative course was uneventful except for transient liquorrhea without tumor regrowth. Fracture of the right femur and paralytic dislocation of the right hip joint necessitated surgical repair.
