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During the years 1941 through 1973, 48 patients, 16 males and 32 females, with sacrococcygeal teratoma were seen at the Childrens Hospital of Los Angeles. Forty-four patients have been followed, three are lost to follow-up, and one patient died 2 wk after excision of teratoma. Of the 44 patients with follow-up, 26 had teratoma with mature tissues only, all these patients are living. Six patients had tumor containing mature and embryonic tissues. Of these, five are living and one died with metastases of malignant teratoma 1 yr after excision of the primary tumor. Of the remaining 12 patients, 11 have died during the first 4 yr of life due to malignant teratoma and only one is living without recurrence 15 yr after excision of teratoma containing frankly neoplastic tissues. Recurrence and/or metastasis of malignant sacrococcygeal teratoma was lethal in all instances.

Serum alpha-fetoprotein (AFP) values in 61 infants and children with mature, immature, or malignant teratoma were analyzed in comparison with the normal ranges of AFP. AFP was within the normal ranges in 23 of 24 mature teratomas, and higher than the upper border of the normal ranges in 31 of 32 malignant teratomas. The number of immature teratomas studied here was very small. These results suggest that the diagnostic value of AFP would seem very high even in infancy and childhood, if data are compared with the normal ranges. This conclusion appears particularly noticeable because the authors had once made a preliminary report on this subject in which they concluded that the differentiation between benign and malignant teratoma by AFP would be impossible under the age of 2 mo.