Barw Barw Medical Journal 2960-1959 2024 12 10 Giant Sacrococcygeal Teratoma in Infant: Systematic Review 10.58742/bmj.v2i4.148 eng Gauri Shankar Shah Department of Pediatrics and Adolescent Medicine B. P. Koirala Institute of Health Sciences Dharan, Nepal. gauri.shah@gmail.com Satoshi Ieiri Department of Pediatric Surgery, Kagoshima University, Kagoshima, Japan. satoshi@gmail.com Wirya N. Sabir Department of Pediatric Surgery, Shar Hospital, Sulaymaniyah, Iraq. wirya.sabr@gmail.com Bilal A. Mohammed Dr. Jamal Ahmad Rashid's Pediatric Teaching Hospital, Qanat Street, Sulaymaniyah, Iraq. bilal.mohammed@gmail.com Shwan Fakhrulddin Abdulaziz Department of Pediatric Surgery, Shar Hospital, Sulaymaniyah, Iraq. shwan@gmail.com Sasan M. Ahmed Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. sasan0751@gmail.com Paiwand Abdulkarim Nadr Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. paiwand.abdulkarim@gmail.com Bander A. Abdalla Kscien Organization for Scientific Research (Middle East Office), Hamdi Street, Azadi Mall, Sulaymaniyah, Iraq. bander.abdalla@gmail.com 2024 11 05 Introduction Sacrococcygeal teratoma (SCT) is a rare embryonal tumor that occurs in the sacrococcygeal region, with an incidence of about 1 in 35,000 to 40,000 live births. This study presents a systematic review of giant SCT greater than 10 cm. Methods A systematic review of published studies regarding giant SCT in infants was conducted. The studies included met the following criteria: 1) the teratoma was situated in the sacrococcygeal region; 2) all case reports involved infants with a teratoma larger than 10 cm, and 3) the size of the teratoma was verified to exceed 10 cm through diagnostic methods. Results The current study included 31 studies that met the inclusion criteria. The studies included patients aged 6.1 to 9.3 months, with a median age of 7.6 months, predominantly female (72.7%). Diagnoses were primarily made in the first and second trimesters (39%) or after birth (33.3%), with cesarean delivery being the most common method (66.7%). Tumors weighed between 1.5 and 5 kg, with an average diameter of 15.6 cm. Surgical resection was performed in 93.9% of cases. The most common complication was respiratory failure (30.3%), and histopathology revealed that 39.4% of tumors were immature teratomas, while 33.3% were mature teratomas. The overall survival rate was 66.7%, with 18.2% of survivors experiencing tumor recurrence. Most complications occurred in the second trimester; however, no significant associations were found concerning the timing of diagnosis. Additionally, tumor size did not significantly impact outcomes. Conclusion Routine ultrasound and MRI are essential for the antenatal diagnosis of SCT. Due to the high risk of morbidity with larger tumors, cesarean delivery is advised for tumors over 10 cm. Coccygectomy is the most effective approach to prevent recurrence, highlighting the importance of timely surgical intervention and ongoing follow-up.