Sacrococcygeal Teratoma

Athena is fascinated by the tailbone (coccyx) for more than one reason: it is named poetically after the beak of a cuckoo; it is the key Darwinian link between the tail of primates and the tailless Homo sapiens; notwithstanding its tiny size it plays a vital role in anal continence by giving attachment to anal sphincters; and above all it harbors totipotent stem cells giving rise to a peculiar tumor the Sacrococcygeal Teratoma (SCT). This tumor is peculiar because it is almost always benign to start with and it turns malignant with passage of time. This emphasizes the importance of early surgery and the need to excise coccyx in SCT. Athena believes that studying the natural history of SCT may unravel the secrets of oncogenesis. Her curiosity is perpetuated by recent reports [1 16] describing as to how these tumors have been mistaken for a variety of other lesions and vice versa (Table 1).