Abstract:
Background: A giant anterior sacral meningocele is a very rare swelling in the sacrococcygeal region and is difficult to diagnose preoperatively, as it does not usually present as an exophytic swelling. The aim is to present a newborn with a giant anterior sacral meningocele masquerading as cystic sacrococcygeal teratoma.
Case scenario: A full-term male neonate (3.5 kg) presented with a giant, cystic sacrococcygeal swelling displacing the anus anteriorly. Imaging studies (CT and MRI) showed no spinal canal communication or sacral defect. MRI favored a diagnosis of cystic sacrococcygeal teratoma. Surgical excision and anorectoplasty were performed via the posterior sagittal approach. Intraoperatively, the cyst contained clear fluid, lacked a defined wall, and histopathology did not confirm teratoma. The postoperative course was uneventful, and the patient was discharged on the 6th postoperative day.
Conclusion: Anterior sacral meningocele can present as a cystic swelling that closely mimics sacrococcygeal teratoma, making preoperative diagnosis difficult. If not correctly identified and repaired properly during surgery, recurrence may occur. A high index of suspicion and meticulous intraoperative assessment are essential for optimal management.
Keywords: Anterior sacral meningocele, sacrococcygeal teratoma, neonatal cystic mass, diagnostic pitfall, posterior sagittal approach.
Biography:
Gamal Al-Saied is a distinguished Egyptian pediatric surgeon and academic affiliated with Al-Azhar University in Cairo, Egypt. He has made significant contributions to pediatric surgery through clinical practice, research, and academic leadership.
Academic and Professional Background:
He graduated from Al-Azhar University with a Bachelor's degree in Medicine and Surgery, earning high honors and ranking 9th among the top 10 graduates of his class. He completed his Master's degree (MSc) in Pediatric Surgery in 1991 and obtained his Doctorate (MD) in Pediatric Surgery in 1998. His academic career at Al-Azhar University progressed from demonstrator to assistant lecturer, lecturer, assistant professor, and ultimately to full professor in 2009.
He holds several prestigious certifications, including:
- Fellowship of the European Board of Pediatric Surgery (FEBPS), awarded in Glasgow, Scotland.
- Fellowship of the American College of Surgeons (FACS).
- Membership of the Royal College of Physicians and Surgeons of Glasgow (MRCPS).
Research and Editorial Contributions:
He has an extensive research portfolio, with 37 international publications in pediatric surgery journals and a chapter in the textbook Current Concepts of Urethroplasty. He has supervised numerous Master's and Doctorate theses and serves as Editor-in-Chief for two international pediatric surgery journals, as well as an editor for thirteen others. His research interests include complex pediatric and neonatal surgical conditions. Leadership and Conference Participation Beyond academia, he is actively involved in the global pediatric surgery community. He has been invited as a speaker and chairperson at various international conferences, including the Global Conference on Surgery and Anaesthesia and the Pediatrics and Neonatology Conference Online Presence he maintains a professional profile on ResearchGate, where he shares his publications and connects with the research community.