Dégénérescence maligne d'un tératome sacro-coccygien avec volumineux kyste du mésentère: à propos d'un cas à Bamako

Malignant sacrococcygeal teratoma is a rare congenital embryonal tumor at high risk of malignant transformation. We report the case of a 20-month old female infant. She was the couple's fourth child. Her mother was 29 years old, she had four pregnancies with vaginal deliveries. All the infants were born alive. The woman was not properly followed during pregnancy. She had vaginal delivery at term and had correctly attended expanded programme on immunization (EPI) with positive reaction to BCG vaccine. The child walked autonomously at 13 months. She had painful fluctuating inguinal and left labium major swelling (A), distended abdomen with oozing wound measuring 4cm/3cm on the right buttock (A). Frontal x-rays of abdomen without preparation showed distended flaccid abdomen with opacity in the periumbilical region as well as in the hypogastric region (B). Ultrasound objectified voluminous calcified sub-vescical tissue mass measuring 87*54 mm (C). Thoracoabdominal CT scan showed calcified sacrococcygeal tissue mass measuring 83*59 mm, with modest fissure in the left pubis and abdominal cyst without wall (D,E). Moreover, there were nodules of variable size in the lungs and the liver (F,G). The infant was treated by an oncopediatric team.