Fetal intrapericardial teratomas

Fetal intrapericardial teratomas are rare and benign. However, they canbe life-threatening owing to the complicated massive pericardial effusions,tamponade, or cardiorespiratory distress. The purpose of this review is togive an overview on clinical features, management and prognoses of fetalintrapericardial teratomas. The materials of this study were based on acomprehensive literature retrieval of fetal intrapericardial teratomas publishedin the past two decades. It was noteworthy that fetal pericardial/pleuraleffusions or ascites were detected since 19-week gestation, and tumors couldbe found since 21-week gestation. A growing trend of tumors was observed inmore than half of the cases. Prenatal centesis and postnatal tumor resectionwere required in most of the cases. Fetoneonatal deaths (including fetaldemise, termination of pregnancy and neonatal death) occurred in one-thirdof the cases. The neonatal survival rate was 59.4%. Symptomatic fetusesusually required perinatal maneuvers, such as pericardiocentesis, or thoraco-/pericardio-amniotic shunt in order to improve fetal hemodynamic status andprolong the pregnancy for lung maturity. Open fetal surgery and ex uterointrapartum treatment (EXIT) procedure can be considered, however, impactof EXIT procedure on later delivery remains uncertain. Postnatal operationis a curative and symptom-relieving method for those cases with prenatallydiagnosed intrapericardial teratomas. As a result, the fetoneonatal outcomesare somewhat promising.

___

1. Banfield F, Dick M 2nd, Behrendt DM, Rosenthal A, Pescheria A, Scott W. Intrapericardial teratoma: a new and treatable cause of hydrops fetalis. Am J Dis Child 1980; 134: 1174-1175.

2. Beghetti M, Prieditis M, Rebeyka IM, Mawson J. Images in cardiovascular medicine. Intrapericardial teratoma. Circulation 1998; 97: 1523-1524.

3. Yuan SM. Cardiac etiologies of hydrops fetalis. Z Geburtshilfe Neonatol 2017; 221: 67-72.

4. Yuan SM. Fetal primary cardiac tumors during perinatal period. Pediatr Neonatol 2017; 58: 205-210.

5. Kulthe SG, Nadkarni UB, Singh A, Deshmukh CT, Jain MK, Shah MD. Recurrent cardiac tamponade: intrapericardial teratoma. Indian Pediatr 1995; 32: 88-91.

6. Aldousany AW, Joyner JC, Price RA, Boulden T, Watson D, Disessa TG. Diagnosis and treatment of intrapericardial teratoma. Pediatr Cardiol 1987; 8: 51-53.

7. Agarwal A, Rosenkranz E, Yasin S, Swaminathan S. EXIT procedure for fetal mediastinal teratoma with large pericardial effusion: a case report with review of literature. J Matern Fetal Neonatal Med 2018; 31: 1099-1103.

8. Bader R, Hornberger LK, Nijmeh LJ, et al. Fetal pericardial teratoma: presentation of two cases and review of literature. Am J Perinatol 2006; 23: 53-58.

9. Cavalcante CTMB, Pinto Júnior VC, Pompeu RG, et al. Early treatment of intrapericardial teratoma: A case presentation and systematic literature review. J Matern Fetal Neonatal Med 2019; 32: 2262-2268.

10.Cetrano E, Polito A, Carotti A. Primitive intrapericardial teratoma associated with yolk sac tumour. Cardiol Young 2015; 25: 158-160.

11.Czernik C, Stiller B, Hübler M, Hagen A, Henrich W. Hydrops fetalis caused by a large intrapericardial teratoma. Ultrasound Obstet Gynecol 2006; 28: 973-976.

12.Daniels CJ, Cohen DM, Phillips JR, Rowland DG. Prenatal detection of a pericardial teratoma. Circulation 1999; 99: E1-E2.

13.de Bustamante TD, Azpeitia J, Miralles M, Jiménez M, Santos-Briz A, Rodríguez-Peralto JL. Prenatal sonographic detection of pericardial teratoma. J Clin Ultrasound 2000; 28: 194-198.

14.Devlieger R, Hindryckx A, Van Mieghem T, et al. Therapy for foetal pericardial tumours: survival following in utero shunting, and literature review. Fetal Diagn Ther 2009; 25: 407-412.

15.Fagiana AM, Barnett S, Reddy VS, Milhoan KA. Management of a fetal intrapericardial teratoma: a case report and review of the literature. Congenit Heart Dis 2010; 5: 51-55.

16.Goldberg SP, Boston US, Turpin DA, et al. Surgical management of intrapericardial teratoma in the fetus. J Pediatr 2010; 156: 848-849, 849.e1.

17.Grebille AG, Mitanchez D, Benachi A, et al. Pericardial teratoma complicated by hydrops: successful fetal therapy by thoracoamniotic shunting. Prenat Diagn 2003; 23: 735-739.

18.Iacona GM, Barber MA, Medina M, Abella R. Intrapericardial teratoma in a low birth weight preterm infant: a successful multidisciplinary approach. Interact Cardiovasc Thorac Surg 2011; 12: 287-289.

19.Kamil D, Geipel A, Schmitz C, et al. Fetal pericardial teratoma causing cardiac insufficiency: Prenatal diagnosis and therapy. Ultrasound Obstet Gynecol 2006; 28: 972-973.

20.Kitagawa N, Ohhama Y, Fukuzato Y, et al. Pericardial hemangioma presenting fetal cardiac tamponade and postnatal bronchostenosis. Pediatr Surg Int 2004; 20: 376-377.

21.Mitanchez D, Grébille AG, Parat S, et al. Delayed surgery in pericardial teratoma with neonatal hydrops. Eur J Pediatr Surg 2005; 15: 431-433.

22.Molina-Mora MJ, Picazo-Antolín B, Cuenca-Peiró V, Miguel Gil-Jaurena J, Zabala-Argüelles JI. Foetal intrapericardial teratoma. Eur J Echocardiogr 2011; 12: 513.

23.Pachy F, Raiffort C, Mechler C, Zilberman S, Mandelbrot L. Intrapericardial teratoma with hydrops leading to in utero demise. Prenat Diagn 2007; 27: 970-972.

24.Ragupathy R, Nemeth L, Kumaran V, Rajamani G, Krishnamoothy P. Successful surgical management of a prenatally diagnosed intrapericardial teratoma. Pediatr Surg Int 2003; 19: 737-739.

25.Ramírez JA, Mon CR, Perez EO, Parugues BD, Pascual GR. Fetal intrapericardial teratoma. Ultrasound Obstet Gynecol 2004; 23: 416-418.

26.Roy N, Blurton DJ, Azakie A, Karl TR. Immature intrapericardial teratoma in a newborn with elevated alpha-fetoprotein. Ann Thorac Surg 2004; 78: e6-e8.

27.Rychik J, Khalek N, Gaynor JW, et al. Fetal intrapericardial teratoma: natural history and management including successful in utero surgery. Am J Obstet Gynecol 2016; 215: 780.e1-780.e7.

28.Skálová H, Povýsil C. Intrapericardial teratoma as a cause of fetal death--a case report. Cesk Patol 2011; 47: 189-191.

29.Steffensen TS, Quintero RA, Kontopoulos EV, GilbertBarness E. Massive pericardial effusion treated with in utero pericardioamniotic shunt in a fetus with intrapericardial teratoma. Fetal Pediatr Pathol 2009; 28: 216-231.

30.Sydorak RM, Kelly T, Feldstein VA, et al. Prenatal resection of a fetal pericardial teratoma. Fetal Diagn Ther 2002; 17: 281-285.

31.Tollens M, Grab D, Lang D, Hess J, Oberhoffer R. Pericardial teratoma: prenatal diagnosis and course. Fetal Diagn Ther 2003; 18: 432-436.

32.Tomek V, Vlk R, Tláskal T, Skovránek J. Successful pericardio-amniotic shunting for fetal intrapericardial teratoma. Pediatr Cardiol 2010; 31: 1236-1238.

33.Nassr AA, Shazly SA, Morris SA, et al. Prenatal management of fetal intrapericardial teratoma: A systematic review. Prenat Diagn 2017; 37: 849-863.

34.Lee H, Hirose S, Harrison MR. Chapter 5 – Prenatal diagnosis and fetal therapy. Pediatric Surgery (7th ed). 2012: 77-88. https://doi.org/10.1016/B978-0-323- 07255-7.00005-2

35.Paw PT, Jamieson SW. Surgical management of intrapericardial teratoma diagnosed in utero. Ann Thorac Surg 1997; 64: 552-554.
Turkish Journal of Pediatrics-Cover
  • ISSN: 0041-4301
  • Yayın Aralığı: 6
  • Başlangıç: 1958
  • Yayıncı: Hacettepe Üniversitesi Çocuk Sağlığı Enstitüsü Müdürlüğü
Sayıdaki Diğer Makaleler

Etiology of vaginal discharge in sexually inactive adolescents

Yasemin DÜZÇEKER, Sinem AKGÜL, Yasemin ÖZSÜREKÇİ, Orhan DERMAN, Ateş KARA, Nuray KANBUR

Renal features of Bardet Biedl syndrome: A single center experience

Bahriye ATMIŞ, Aysun Karabay BAYAZIT, Engin MELEK, Atıl BİŞGİN, Ali ANARAT

Bismuth intoxication resulting in acute kidney injury in a pregnant adolescent girl

Aslı Çelebi TAYFUR, Raziye Merve YARADILMIŞ, Fatma ULUS, Aysun Çaltık YILMAZ, Esra ÖZAYAR, Berrin KOŞAR, Bahar BÜYÜKKARAGÖZ, Eyüp HORASANLI

Evaluation of growth in children and adolescents after renal transplantation

Bahar BÜYÜKKARAGÖZ, Sevcan Azime BAKKALOĞLU, Ayşe Fitnat TUNCEL, Banu Kadıoğlu YILMAZ, Deniz KARCAALTINCABA, Hatice PAŞAOĞLU

Priapism: A rare presentation of precursor B-Cell acute lymphoblastic leukemia

Zeliha GÜZELKÜÇÜK, Dilek KAÇAR, Rabia DEMİR, Meltem KÜRTÜL, Hüsniye Neşe YARALI, Namık Yaşar ÖZBEK

Alpha methyl acyl CoA racemase deficiency: Diagnosis with isolated elevated liver enzymes

Mehmet GÜNDÜZ, Özlem ÜNAL, Aynur Küçükçongar YAVAŞ, Çiğdem KASAPKARA

Comparison of i-gel, LMA-supreme, LMA-classic and LMAproseal as conduits of endotracheal intubation in newborns and infants: A manikin study

Aysun Ankay YILBAŞ, Betül BAŞARAN, Filiz ÜZÜMCÜGİL, Başak AKÇA, Murat İZGİ, Özgür CANBAY

First report of human ehrlichiosis in Turkey

Melike EMİROĞLU, Bekir ÇELEBİ

Invasive fungal infection in children with hematologic malignancy

Belgin GÜLHAN, Saliha Kanık YÜKSEK, Aslınur Özkaya PARLAKAY, Neşe YARALI, Hasan TEZER, Namık Yaşar ÖZBEK

Neonatal form of biotin-thiamine-responsive basal ganglia disease. Clues to diagnosis

Aydan DEĞERLİYURT, Mehmet GÜNDÜZ, Serdar CEYLANER, Özlem ÜNAL