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fly a kite and seize the day

Silvia Rivas and her husband, Javier Alvarez, of Bakersfield were overjoyed when she became pregnant with their fifth child. That joy soon turned to confusion and worry when they learned their little boy in utero had a rare, serious condition.

An ultrasound at five months’ gestation showed a large mass growing on their son Matthew’s tiny tailbone (coccyx). “I was very upset,” recalled Rivas, then 37. “All of my other kids were fine. I thought, ‘What did I do wrong?’”

Rivas was referred to the Maternal Fetal Center at Children’s Hospital for further evaluation and treatment. Dr. Armando Fuentes, medical director, perinatology, who specializes in high-risk pregnancies, counseled the couple and they exchanged doubt and fear for encouragement. “Dr. Fuentes gave us hope,” said Rivas.

Matthew was diagnosed with a sacrococcygeal teratoma (SCT). These tumors, composed of a chaotic mix of tissue – fat, bone, nerves, etc. – can be external, internal or both. The cause is unknown.
“We’ve only had two cases like this in the past several years,” said Dr. Michael Allshouse, medical director, pediatric surgery and trauma.
Usually not harmful, these masses may grow during pregnancy and develop very large blood vessels.

This can strain the baby’s heart, potentially leading to fetal heart failure, preterm delivery and danger for the maturing baby and mom.

Rivas underwent a fetal MRI scan to determine how far Matthew’s tumor extended internally. “When you have a baby with severe problems, it can be a dark place for parents,” said Dr. Allshouse. “The more information we can determine before the birth, the more time parents can prepare mentally and emotionally, and have a course of action.”
Dr. Fuentes extended Rivas’ pregnancy as long as possible through medications and intense monitoring. He was pleased Rivas didn’t deliver until 35 weeks. Matthew was then transported to Children’s to surgically remove the mass, which ruptured during birth.

“Matthew’s tumor was as big as his torso,” said Dr. Stephanie Jones, a pediatric surgeon who teamed with Dr. Allshouse to remove Matthew’s tailbone and reconstruct his bottom. “This type of surgery is what we can do well at a tertiary center.” At 16 months, Matthew continues to do well.

“Now he’s just like any other happy baby,” said Rivas smiling while holding Matthew during a follow-up visit. “We can’t ask for more than that.”


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