Fetal intrapericardial teratoma

a case report

Abstract

INTRODUCTION: Primary cardiac tumors, including teratomas, are rare and usually diagnosed either intrauterine or postnatally. Intrapericardial teratoma is the second most common benign cardiac tumor in fetuses and can cause complications such as cardiac tamponade and fetal hydrops, leading to death. This report describes a rare case of fetal intrapericardial teratoma detected by ultrasound in a high-risk maternity unit. CASE REPORT: A 32-year-old pregnant woman was diagnosed with a 32mm mediastinal mass, associated with pericardial effusion, mediastinal shift, and risk of hydrops. The patient was referred to another hospital for pericardiocentesis and tumor sclerosis procedures. Despite these attempts, the fetus developed hydrops and, after delivery by cesarean section, died due to pulmonary hypoplasia. DISCUSSION: Early fetal diagnosis of cardiac tumors has become more accurate with advancements in imaging techniques. Intrapericardial teratomas are rare tumors that can lead to cardiac compression and fetal death. Early diagnosis is crucial for proper management, allowing interventions such as pericardiocentesis or surgical resection. Fetal surgery is a therapeutic option when available and performed before hydrops develops. CONCLUSION: Early management and fetal surgery could have changed the prognosis in this case. Prompt referral to specialized centers is essential to improve perinatal outcomes.