Prenatal sonographic detection of pericardial teratoma

Abstract

Patients with pericardial teratomas usually present shortly after birth with cardiorespiratory distress or in utero with hydrops fetalis. We report a case in which the tumor was diagnosed in utero using sonography during a routine obstetric examination. Sonograms showed a 3-cm echogenic mass compressing the right atrium. The lesion was inhomogeneous with solid and cystic areas. The fetus was followed to term, and additional radiologic studies were performed before the infant underwent surgery. Prenatal identification of a pericardial teratoma is essential for planning fetal management and delivery and potential prenatal surgery.

Pericardial Disease in Pregnancy

“…Pericardial teratomas and rhabdomyomas ( Figure 3) are rare congenital tumors that invade the developing mediastinum, compressing the venous return to the heart, leading to hydrops [26,27]. Tumors, with large cystic components, have been treated previously with in utero pericardiocentesis with some success [28,29].…”

Intrapericardial teratoma in the perinatal period

“…The fibrous attachment is a conduit for adventitial vessels from the aorta, providing a vascular supply to the tumor [14]. The tumor mass may demonstrate compression of the right atrium and/or ventricle, creating hemodynamic compromise, ultimately resulting in hydrops, pericardial effusion, and polyhydramnios [3,37]. Computed tomography scan, performed early in the neonatal period, supports the diagnosis of pericardial teratoma if the characteristic features of fat density tissue in combination with calcifications are found in the mass.…”

“…Computed tomography scan, performed early in the neonatal period, supports the diagnosis of pericardial teratoma if the characteristic features of fat density tissue in combination with calcifications are found in the mass. The findings of a large pericardial effusion or pericardial thickening may suggest teratoma rupture [37]. A space-occupying lesion within the pericardium, with relatively little compression of the lung spaces, is very suggestive of an intrapericardial teratoma.…”

Neonatal intrapericardial teratoma: a challenge for the pediatric surgeon

“…Intracardiac and intrapericardial teratomas are rare but are potentially fatal [1][2][3]. Less than 20 cases in alive newborns have been described in the last 15 years [2,[4][5][6].…”

“…Because of the specific clinical features of the lesion, definitive diagnosis may be obtained only with hystologic examination. Nowadays, prenatal diagnosis and early treatment of pericardial teratomas are increasingly possible [1,2,4,7]. This report describes a case of intrapericardial teratoma complicating a singleton pregnancy.…”