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(Circulation. 1998;97:1523-1524.)
© 1998 American Heart Association, Inc.

Images in Cardiovascular Medicine

Intrapericardial Teratoma

Maurice Beghetti, MD; Mark Prieditis, MD; Ivan M. Rebeyka, MD, FRCSC; John Mawson, MBChB; ; FRACR, FRCPC

From the Divisions of Cardiology (M.B.) and Cardiovascular Surgery (I.M.R.) and the Department of Diagnostic Imaging (M.P., J.M.), The Hospital for Sick Children, University of Toronto, Canada.

Correspondence to Dr John Mawson, Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada.

A 1-month-old boy presented with signs of heart failure and tamponade. Two-dimensional echocardiography revealed a complex mass with a large pericardial effusion compressing the heart. Magnetic resonance imaging (Fig 1) defined the relationship of the mass to the pericardium, myocardium, and great vessels. Complete surgical resection was performed without complication (Fig 2). Histology of the mass confirmed the presumptive imaging diagnosis of teratoma. The patient remains free of symptoms and tumor 1 year after surgery.

View larger version (115K): [in this window] [in a new window]   Figure 1. Magnetic resonance imaging. Axial T1-weighted spin-echo images. A, Main tumor mass (*) is seen displacing mediastinal structures. Thymus (THYM) is displaced rightward and superiorly (not shown), while aorta (AO) and main pulmonary artery (MPA) are displaced posteriorly and splayed. B, Intrapericardial nature of the tumor is demonstrated on a lower image, with tongues of tumor (*) projecting into pericardial space, indenting right atrium (RA). There is an effusion (Eff) and pericardial thickening (arrowheads). LA indicates left atrium.

View larger version (105K): [in this window] [in a new window]   Figure 2. Gross specimens following surgical resection. A, Tumor bulk is clearly seen, as are two tumor tongues (*) identified in Fig 1B. B, On cut section, cystic and solid nature of lesion is demonstrated, correlating well with variations in signal intensity seen in main tumor mass in Fig 1A.

Intrapericardial teratomas are rare primary cardiac tumors usually diagnosed in neonates and infants.^{1 2} They contain endodermic, mesodermic, and neuroectodermic germinal layers.³ Intrapericardial teratomas are usually benign tumors but may be life-threatening because of large pericardial effusion and cardiac compression.^{1 2} Echocardiography generally . . . [Full Text of this Article]

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