INTRAPERICARDIAL TERATOMA: A CAUSE OF ACUTE PERICARDIAL EFFUSION IN INFANCY

Abstract

On the basis of personal experience with two patients and a review of the 35 previously reported cases, we described the pathologic and clinical features of intrapericardial teratoma. This tumor is single, large, encapsulated, multicystic, and pedunculated. It is attached by a short fibrous stalk or pedicle to the adventitia of one or both great arteries. Only 2 of the 37 intrapericardial teratomas were malignant. The tumor is found predominantly in children, usually during early infancy, and among cardiac tumors of childhood it is second only to rhabdomyoma in frequency. Acute or chronic pericardial effusion commonly accompanies the teratoma. All young infants reported have had acute pericardial effusion with tamponade. Typically, the associated fluid is serous, sterile, copious, and recurrent; it usually obscures the presence of the tumor. Intrapericardial teratoma is a likely diagnosis in any young infant having such penicardial effusion; other cardiac tumors do not have these clinical features. Artificial pneumopericardium will demonstrate the teratoma, and operation is curative if the tumor is benign. Uncontrollable bleeding from the aorta on dissection of the tumor stalk has been an operative hazard; but, if anticipated, it can be avoided.