He Takes My Heart With Him

A Sacrococcygheal Teratoma

Dr. R. said, "Well, let's take a look at your baby and see what's going on." He ran the wand over my stomach and pointed out different things he was looking at. "The head is a nice, round shape." "Do you see this valve in the heart? That's a perfect picture! Wow, this is a really cooperative baby you have here!" All over, commenting on our baby's beautiful kidneys and large feet. Then, he said, "Okay, let's get to why you're here." and started scanning our baby's spine.

He moved slowly down the spine, until he found the small, round circle. He switched to a higher magnification, measured the circle, took picture after picture, switching angles over and over. Finally, he leaned back and, keeping the circle in focus, told us what he thought.

"The circle is on the bottom of the spine. It doesn't appear to involve the bones. It is fully encased, with no leaks or breaks. It also protrudes, slightly, out his back. I think this is a sacrococcygheal teratoma."

I couldn't breathe. He kept talking, but I couldn't hear him, anymore. I had researched this. This teratoma is a mass of tissues, bones, and, possibly, teeth. Three germ cell layers, they call it. It also can be malignant. Cancer. Although, most of them are benign, but we hadn't had good luck with the odds, yet.

Worse, it can grow, rapidly, to huge proportions. I had seen pictures where the mass connected to the back of the baby was as big as the baby itself. Because of how it is made and connected, blood is pumped through it. As it gets bigger, it taxes the baby's heart, trying to pump blood through the baby and this huge mass. If it gets big enough, it can cause the baby's heart to fail. Or it can rupture.

It can involve the baby's internal organs. Either pushing on them and not allowing them to grow properly, or growing around them and not allowing them to function.

Some babies have, and need, surgery in utero. Some babies need to be delivered via c-section to minimize the risk of rupturing the mass. Surgery is needed immediately after delivery. Even if the surgery is successful, and the mass is benign, it can grow back again. At any time. And then it can be malignant. Some babies never make it that far. Some babies never even make it to delivery.

I began crying and Dr. R. told me not to worry. Somehow, that didn't make me angry. Instead, he told me, "Your baby's mass is really small. Only about 1 centimeter in diameter. That's really good. You will have an ultrasound every four weeks to check if it's getting bigger. But I really don't anticipate that happening." Why he didn't, I still don't know.

He told us to call if we had any questions or if anything seemed "different." He told us the nurses were used to working with parents who needed extra reassurance and would be happy to talk with us at any time. He told us that he was taking over my care. He smiled and told me not to worry. And, again, I felt safe. My eyes still filled with tears, I smiled back and shook his hand.