Two-thirds of all teratomas seen in 31 Nigerian children at Ibadan were situated in the sacrococcygeal region. About one-quarter of all the sacrococcygeal teratomas were malignant as shown on radiological and pathological examinations. The malignant tumours had papillary carcinomatous pattern, probably derived from the choroid plexus. The clinicopathological features of one patient with malignant change is described to illustrate the biological behaviour of this tumour. Malignancy in all the sacrococcygeal tumours appears to be associated with growth of the tumour into the pelvic cavity and metastasis initially to inguinal lymph nodes and later to distant sites. Inferior venacavogram can be of great value in defining the extent of the intrapelvic mass and the displacement of the genito-urinary organs, particularly when surgery is contemplated.
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