Answer to the case of the week #251

September 3 - September 17, 2009

Irina Tihonenko, MD; Tatiyana Koipish, MD.

Prenatal Diagnostic Ultrasound Center, Minsk, Belarus.

Case report

A 32-year old woman (G2P1), with non contributive history, presented to our center at 33 weeks for a routine ultrasound examination. Her 20 weeks" ultrasound was normal. Our examination revealed a heterogenous multilocular cystic tumor within the pericardium of the fetal heart. The finding was suggestive of pericardial teratoma. No hemodynamic changes were observed. The fetus was delivered at term vaginally. Three months later the neonate underwent an operation in Germany and the histological diagnosis confirmed the diagnosis of the mature pericardial teratoma.

Images 1, 2: 33 weeks of pregnancy; the images show four-chamber view of the heart. No significant findings are visible on these scans.

 

Images 3, 4: 33 weeks of pregnancy; the images represent transverse scans of the fetal thorax obtained by a slight angulation of the probe from the four-chamber view of the heart depicted on the images 1 and 2. An inhomogeneous (cystic and solid) mass of the pericardial teratoma can bee seen within the pericardium (the mass is marked by red color on the image 4).

 

Images 5, 6: 33 weeks of pregnancy; the images represent transverse, slightly angulated, views of the fetal heart with an inhomogeneous (cystic and solid) mass of the pericardial teratoma within the pericardium (the mass is marked by red color on the image 6).

 

Images 7, 8: 33 weeks of pregnancy; the images represent four chamber views of the heart with normal filling of the atria and ventricles. The tumorous mass of the pericardial teratoma is not visible on these scans. (RA - right atrium, LA - left atrium, RV - righ ventricle, LV - left ventricle).

 

Images 9, 10: 33 weeks of pregnancy; the images represent color Doppler transverse, slightly angulated, views of the fetal heart with an inhomogeneous (cystic and solid) mass of the pericardial teratoma within the pericardium (the mass is marked by red color on the image 6). The filling of the hart chambers doesn"t seem to be affected.

 

Images 11, 12: 33 weeks of pregnancy; the images represent color Doppler transverse, slightly angulated, views of the fetal heart with an inhomogeneous (cystic and solid) mass of the pericardial teratoma within the pericardium (the mass is marked by red color on the image 6). The filling of the hart chambers and the left outflow jet (red flow on the image 12) don"t seem to be restricted.

 

Images 13, 14: 33 weeks of pregnancy; the images represent detailed transverse scan through the cystic and solid mass of the pericardial teratoma.

 

Videos 1, 2, and 3: 33 weeks of pregnancy; the videos show a few views of the fetal heart with the percardial teratoma.

 

 

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