Fig. 5

A 22-year-old pregnant female with late 1st trimester and another early 2nd trimester US revealing large fetal sacral mass lesion. Ultrasound findings: A, B Axial and coronal sections of the fetal lower back showing a large mixed solid and cystic mass lesion arising from the fetal sacral region with small intra-spinal extension and extensive neovascularization on Doppler interrogation. C Axial image at the level of fetal liver revealing marked skin thickening and subcutaneous edema. MRI findings: D, E, F axial, and sagittal T2WIs revealing the mixed solid and cystic sacral mass lesion with its smaller pelvic extension (arrowed) at the level of the fetal urinary bladder and actual size of intra-spinal extension (arrowed). Note associated diffuse fetal subcutaneous edema. Combined US and MRI Diagnosis: A large mixed solid and cystic highly vascular fetal sacrococcygeal teratoma with a smaller intra-pelvic and intra-spinal extension (stage IV) and complicated fetal hydrops. IUFD at 30 weeks