Sacrococcygeal Teratomas in Currarino Syndrome: A Multicenter Review of Tumor Characteristics, Surgical Outcomes, and Recurrence.
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BACKGROUND: Currarino syndrome is a rare congenital condition characterized by a triad of anorectal malformation, sacral agenesis, and presacral mass, often a teratoma. Comparative outcomes of sacrococcygeal teratomas (SCTs) in Currarino versus non-syndromic cases are not well defined. METHODS: A multicenter retrospective review of pediatric SCT resections from 2010 to 2020 was conducted across 11 institutions in the Midwest Pediatric Surgery Consortium. Patients were classified based on the presence or absence of Currarino syndrome. Demographic, surgical, pathologic, and long-term outcome data were analyzed. The primary outcome was tumor recurrence. RESULTS: Of 203 patients, 25 (12.3 %) had Currarino syndrome. Currarino patients were more often diagnosed postnatally (80 % vs. 25 %, p < 0.001) and had predominantly Altman type IV tumors (87 % vs. 17 %, p < 0.001). All tumors in the Currarino cohort were mature teratomas, while 27 % of non-Currarino tumors were immature and 12 % were malignant (p < 0.001). Tumors in Currarino patients were significantly smaller in size (median 3.3 cm vs. 8.0 cm, p < 0.001). Recurrence rates were low and comparable (4 % Currarino vs. 10 % non-Currarino, p = 0.18). Currarino patients had higher rates of urinary incontinence (44 % vs. 28 %, p = 0.048) and constipation (76 % vs. 32 %, p < 0.001). Kaplan-Meier analysis showed a trend toward improved recurrence-free survival in Currarino patients, though not statistically significant. CONCLUSIONS: Pediatric patients with Currarino-associated SCTs have excellent long-term outcomes, with low recurrence rates likely attributable to benign tumor histology and high rates of complete resection. These findings suggest that surveillance strategies may be tailored for Currarino patients to reduce unnecessary imaging and long-term follow-up burden. STUDY DESIGN: Retrospective cohort study. LEVEL OF EVIDENCE: III.