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2017-06-19  Case of the week # 451  © Alexey Ilin  www.TheFetus.net

Answer to the case of the week # 451
August 3, 2017 - August 17, 2017

Alexey Ilin, MD, PhD

Head of the Congenital Heart Department - 
The Federal State Center of Cardiovascular Surgery, Krasnoyarsk, Russian Federation.
 


Case report

The following images revealed a case of a young woman with unremarkable history who came to our unit at 24 weeks of gestation. Our ultrasound examination revealed a tumor in contact with the fetal heart. The tumor had been producing liquid rapidly into the pericardium with compression of the heart and left lung.
On the 28th week of gestation we performed a pericardiocentesis due to compressoin of the heart and lungs had become severe, and we needed to do it twice, at 28th and 32nd weeks, evacuation 70-80ml of liquid.
The baby was delivered through C-section at 35 weeks of gestation and a surgery was performed at the 2nd day of baby´s life.
The tumor was histologically evaluated and it was a well differentiated pericardial teratoma with muscular and cartilaginous differentiation, and components of intestine epithelium and brain tissue.



Images 1, 2; videos 1 and 2: 2D images of the fetal heart showing a large pericardial tumor with pericardial effusion and secondary compression of the lungs and heart.

 
 



Images 3, 4: postnatal CT with endovenous contrast in axial and coronal planes showing a large hypodense tumor, with solid and cystic areas, compressing and deviating the heart.

 



Videos 3, 4, 5 and 6: exeresis of the pericardial tumor.

  



Image 5: histological analysis of the fetal tumor revealed a well differentiated pericardial teratoma with muscular and cartilaginous differentiation, and components of intestine epithelium and brain tissue.

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