Intrapericardial Immature Teratoma with Successful Treatment in a Neonate

Abstract

Intra-pericardial teratoma, most often a benign tumor, is an extremely rare condition in a newborn. It can be a diagnostic and therapeutic challenge if it presents with massive pericardial effusion. Complete surgical excision of the tumor is necessary because of its association with tissues of malignant potential. A 16-d-old newborn was diagnosed with intra pericardial immature teratoma (IT) and managed successfully with multidisciplinary team approach by prompt referral for complete surgical resection followed by adjuvant chemotherapy with carboplatin, etoposide and bleomycin (JEB) to prevent recurrence. The infant is now on close follow up with monitoring of serum alpha fetoprotein (AFP) levels and imaging studies for early diagnosis of recurrence of tumor and chemotherapy related complications.

Fetal Intrapericardial Teratomas: An Update

“…In total, 61 cases of intrapericardial teratomas were included in this study. The intrapericardial teratomas were found during pregnancy in 55 (90.2 %) cases (fetal group) , whereas the tumors were detected in the neonatal period in 6 (9.8 %) cases (neonatal group) [52][53][54][55][56][57].…”

“…The arising sites of the tumors were described for 3 patients, arising from the aorta in 2 patients (66.7 %) [52,55] and the pulmonary trunk in 1 (33.3 %) patient [57]. The clinical symptoms of the neonates were respiratory distress in 3 patients (50 %) [53,54,56], and in 1 (16.7 %) patient each respiratory distress with cardiac tamponade [55], tachypnea [57], and cyanosis [52]. Pericardial effusions were present in 4 (66.7 %) patients, with a small [53], moderate [57], large [55], and unknown amount [54], respectively.…”

“…The clinical symptoms of the neonates were respiratory distress in 3 patients (50 %) [53,54,56], and in 1 (16.7 %) patient each respiratory distress with cardiac tamponade [55], tachypnea [57], and cyanosis [52]. Pericardial effusions were present in 4 (66.7 %) patients, with a small [53], moderate [57], large [55], and unknown amount [54], respectively. Neonatal intubation was required in 1 (16.7 %) patient [56].…”

“…All 6 patients recovered without any complications. The α-fetoprotein levels were reported for 2 patients: it was described as 2,327 ng/mL after the operation in one [54], and gradually decreased in another [55]. The gross pathology of the tumors was reported for 4 (66.7 %) patients: it was cystic in 3 (75 %) patients [55][56][57], and cystic with solid areas in 1 (25 %) patient [52].…”

“…The gross pathology of the tumors was reported for 4 (66.7 %) patients: it was cystic in 3 (75 %) patients [55][56][57], and cystic with solid areas in 1 (25 %) patient [52]. The histology of the tumors was reported for 4 (66.7 %) patients: it was immature in 3 patients (75 %) [54][55][56], and mature in 1 (33.3 %) patient [57].…”