Invasive sacrococcygeal Teratoma-CT

6 year old child with evidence of large  (appx 10 x 8.7cm in transverse sections) infiltrating and poorly marginated mass in the left gluteal region with solid component and patchya areas of fat density infiltraing the gluteal muscles, extending into left ischiorectal fossa with loss of planes and displacement of rectum. There is intrapelvic extensionthrough the sciatic notch and displaces the rectosigmoid. There is widening of spinal canal and intraspinal extension of the mass. There is evidence of left inguinal lymphadenopathy.

Findings indicate fat containing mitotic infiltrative etiology, with extrapelvic, perineal, intrapelvic and intraspinal extension-possible lymphnodal spread- possibilities include sacrococygeal teratoma versus differentials. Histopathological correlation suggested.