Fetal Intrapericardial Teratomas: An Update

Abstract

Fetal intrapericardial teratomas are rare and benign cardiac tumors. By comprehensive literature retrieval of the pertinent articles published since 2000, 49 articles with 61 cases of intrapericadial teratomas were recruited into this study. The intrapericardial teratomas were found during pregnancy in 55 cases (fetal group), while the tumors were detected until neonatal period in 6 cases (neonatal group). In the fetal group, 15 cases were critical with fetal/neonatal respiratory distress or cardiac tamponade. Antenatal treatments including centesis, shunt placement, open fetal surgery and the ex utero intrapartum treatment were required in 24 (43.6%) fetal cases. Postnatal intubation was required in 19 cases with 18 of them having immediate intubation after birth. Postnatal tumor resection was performed in 41 (95.3%) cases. In neonatal group, 4 neonates had respiratory distress and/or cardiac tamponade. Neonatal intubation was required in 1 (16.7%) patient. Surgical tumor resection was performed in all 6 patients. A comparison between the fetal and neonatal groups revealed that the fetal group was associated with higher refractory effusions while the neonatal group had a higher incidence of respiratory distress. Although the all cause death rate was higher in the fetal group than in the neonatal (25.5 vs. 0%), but lack of a statistical significance. Antenatal treatments for fetal intrapericardial teratomas are feasible but carry higher risks in comparison to neonatal cases.

Applicability of Fetal Doppler Ultrasound to Identify Alterations Suggestive of Extra-Cardiac Anomalies (First Part)

“…(18)(19)(20)(21) Cardiac output for the right and left ventricle was estimated by pulsed wave Doppler interrogation through the pulmonary and aortic valves, respectively, using the formula: flow = [3.14 × semilunar valve radius2 × velocity-time integral × heart rate] / estimated weight in kilograms , the normal combined right and left cardiac output in the fetus is 400 to 500 ml / kg / min. (20)(21)(22)(23)(24) FETAL PULMONARY ARTERY: its measurement under fetal Doppler ultrasound is a predictor of neonatal respiratory distress, its diagnosis is evaluated by measuring the pulsatility index (PI), resistance index (IR) and the relationship between acceleration time and execution time (TA / TE) , while for now the pulsatility indices (IP) and resistance index (IR) do not show a greater contribution, the relationship between acceleration time and execution time (TA / TE) a cut-off point> 0.3 refers to prognostic sensitivity. (25) CYSTIC ADENOID: Pulmonary cystic adenoid malformation (CCAM) is a rare abnormality of lung development, in most diagnosed cases the lesion is unilateral and in a single lung lobe, this pathology does not benefit from Doppler ultrasound.…”

Fetal Presentation of Mediastinal Immature Teratoma: Ultrasound, Autopsy and Cytogenetic Findings

“…The differential diagnosis includes bronchogenic cysts, congenital cystic adenomatoid malformation (CCAM) of the lung, diaphragmatic hernia, or bronchopulmonary sequestration [ 4 , 9 ]. Although located in the mediastinum, fetal intrapericardial teratomas are considered cardiac tumors, as their origin is typically from the right anterior border of the heart [ 10 , 11 ].…”