In the mirror syndrome, maternal symptoms
mime foetal and placental oedema. The pathogenesis
is unknown. The most common etiologic associations
are rhesus isoimmunization, twin-twin
transfusion syndrome and viral infections. Few reports
are associated to foetal tumors and particularly
to sacroccoccigeal teratoma (SCT). Based on several
published series, foetal SCT with placentomegaly
and hydrops is almost universally fatal;
foetal surgery is not typically offered for hydropic
foetuses beyond 26 weeks of gestational age. Delivery
of the foetus is the choise treatment when mirror
syndrome is present with supporting the pregnancy
until delivery is necessary for maternal indications
or the foetus is 30 weeks old. The management
of a patient with large foetal sacrococcygeal
teratoma, hydrops foetalis and early onset mirror
syndrome is presented