Fetal pericardial teratoma

Dr Henry Knipe and Dr Yuranga Weerakkody et al.

Fetal pericardial teratomas are rare pericardial teratomas that present in utero. They are an uncommon primary cardiac tumour occurring in a fetus.

It is a type of germ cell tumour and arises from multipotential cells derived from all three germinal layers. In contrast to ovarian teratomas, intrapericardial teratomas usually contain no hair, sebaceous glands or squamous epithelium, although calcifications are reported.

Intrapericardial teratomas are almost always pedunculated, with attachment to the aortic root or pulmonary vessels and are invariably associated with a pericardial effusion.

Tumours can reach a large size (up to  2-3 times that of the normal fetal heart).

Most are juxtoposed to the right side of the heart causing vascular compression with growth but left-sided teratomas have been reported. The most common origin is the base of the heart adjacent to the right atrium.

Most teratomas are of mixed echogenicity with cystic areas or calcifications. Almost all are associated with fetal pericardial effusion. They may demonstrate increased vascularity on Doppler interrogation.

  • an associated pericardial effusion or mass effect may cause extrinsic compression on the heart and cardiac tamponade
  • it also impedes venous return with resultant hydrops fetalis and fetal death

It is a benign tumour and in selcted cases, resection can be curative. Despite is benign nature it can carry significant morbidity and mortality due to associated complications. Intra uterine pericardiocentesis has been performed in selcted cases to relieve fetal hydrops 9.

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Article information

rID: 15551
Section: Pathology
Synonyms or Alternate Spellings:
  • Fetal pericardial teratomas
  • In utero pericardial teratoma
  • Prenatal pericardial teratoma
  • Fetal intra pericardial teratoma

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