Download PDF
Ultraschall Med 2006; 27(6): 577-581
DOI: 10.1055/s-2005-858939
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Intrapericardial Teratoma in the Newborn - 3D-Echocardiography and Course of Disease

Neonatales intraperikardiales Teratom - 3D-Echokardiographie und VerlaufU. Herberg1 , C. Berg2 , G. Knöpfle3 , C. Schmitz4 , D. Kamil2 , U. Gembruch2 , J. Breuer1
  • 1Department of Pediatric Cardiology, University of Bonn, Germany
  • 2Department of Obstetrics and Prenatal Medicine, University of Bonn, Germany
  • 3Department of Pediatric Pathology, University of Bonn, Germany
  • 4Department of Cardiac Surgery, University of Bonn, Germany
Further Information

Publication History

received: 28.7.2005

accepted: 27.9.2005

Publication Date:
22 February 2006 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Intraperikardiale Teratome sind sehr seltene Tumore, die durch eine Kompression mediastinaler Strukturen lebensbedrohlich werden können. Frühzeitige Diagnosestellung und präzise Evaluation sind für das therapeutische Vorgehen unabdingbar. Wir berichten über einen Fall, bei dem die Diagnose eines großen intraperikardialen Teratoms in der 25 + 0. Schwangerschaftswoche gestellt wurde. Postnatal erwies sich insbesondere die 3D-sonographische Untersuchung hilfreich, um einen umfassenden Eindruck der dreidimensionalen Struktur des komplexen Tumors zu erhalten, seine Ausdehnung sowie seine Insertion zu bestimmen. Dieser Fall illustriert den Einsatz neuer, nicht invasiver echokardiographischer Techniken für das therapeutische Management und die chirurgische Therapie insbesondere bei kritisch kranken Patienten.

Abstract

Intrapericardial teratoma is a rare tumour which may become life threatening when it causes mediastinal compression. Early sonographic detection and careful evaluation is necessary for further management. In this paper, we present a case with a large intrapericardial teratoma diagnosed in utero (25 + 0 weeks). After birth, 3D-echocardiography was particularly helpful in obtaining a comprehensive view of the three-dimensional structure of this complex tumour, in order to determine tumour extension and attachment before surgical excision. This case illustrates the opportunities which new, noninvasive echocardiographic tools create to aid therapeutic management and surgical therapy of critically ill patients.

Key words

Teratoma - pericardium - three-dimensional echocardiography - prenatal diagnosis - cardiac surgery

References

  • 1 Isaacs H Jr. Fetal and neonatal cardiac tumors.  Pediatr Cardiol. 2004;  25 252-273
    PubMedGoogle Scholar
  • 2 Beghetti M, Gow R M, Haney I. et al . Pediatric primary benign cardiac tumors: a 15-year review.  Am Heart J. 1997;  134 1107-1114
    CrossrefPubMedGoogle Scholar
  • 3 Holley D G, Martin G R, Brenner J I. et al . Diagnosis and management of fetal cardiac tumors: a multicenter experience and review of published reports.  J Am Coll Cardiol. 1995;  26 516-520
    CrossrefPubMedGoogle Scholar
  • 4 Grebille A G, Mitanchez D, Benachi A. et al . Pericardial teratoma complicated by hydrops: successful fetal therapy by thoracoamniotic shunting.  Prenat Diagn. 2003;  23 735-739
    CrossrefPubMedGoogle Scholar
  • 5 Bustamante T D, Azpeitia J de, Miralles M. et al . Prenatal sonographic detection of pericardial teratoma.  J Clin Ultrasound. 2000;  28 194-198
    CrossrefPubMedGoogle Scholar
  • 6 Riskin-Mashiah S, Moise K J Jr, Wilkins I. et al . In utero diagnosis of intrapericardial teratoma: a case for in utero open fetal surgery.  Prenat Diagn. 1998;  18 1328-1330
    CrossrefPubMedGoogle Scholar
  • 7 Tollens M, Grab D, Lang D. et al . Pericardial teratoma: prenatal diagnosis and course.  Fetal Diagn Ther. 2003;  18 432-436
    CrossrefPubMedGoogle Scholar
  • 8 Sydorak R M, Kelly T, Feldstein V A. et al . Prenatal resection of a fetal pericardial teratoma.  Fetal Diagn Ther. 2002;  17 281-285
    CrossrefPubMedGoogle Scholar
  • 9 Pratt J W, Cohen D M, Mutabagani K H. et al . Neonatal intrapericardial teratomas: clinical and surgical considerations.  Cardiol Young. 2000;  10 27-31
    CrossrefPubMedGoogle Scholar
  • 10 Fritz G A, Riccabona M, Weitzer C. et al . Three-Dimensional Ultrasound (3DUS) of the Neonatal Brain: Clinical Application in Patients of the Neonatal Intensive Care Unit (NICU).  Ultraschall Med. 2005;  26 299-306
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Merz E, Welter C. 2D and 3D Ultrasound in the Evaluation of Normal and Abnormal Fetal Anatomy in the Second and Third Trimesters in a Level III Center.  Ultraschall Med. 2005;  26 9-16
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Marx G R, Sherwood M C. Three-dimensional echocardiography in congenital heart disease: a continuum of unfulfilled promises? No. A presently clinically applicable technology with an important future? Yes.  Pediatr Cardiol. 2002;  23 266-285
    CrossrefPubMedGoogle Scholar
  • 13 Bu L, Munns S, Zhang H. et al . Rapid full volume data acquisition by real-time 3-dimensional echocardiography for assessment of left ventricular indexes in children: a validation study compared with magnetic resonance imaging.  J Am Soc Echocardiogr. 2005;  18 299-305
    PubMedGoogle Scholar
  • 14 Göbel U, Calaminus G, Engert J. et al . Teratomas in infancy and childhood.  Med Pediatr Oncol. 1998;  31 8-15
    CrossrefPubMedGoogle Scholar

Dr. U. Herberg

Department of Pediatric Cardiology, Children’s Hospital, University of Bonn

Adenauerallee 119

53113 Bonn

Germany

Phone: ++49/2 28/2 87 33 50

Fax: ++49/2 28/28 73 36 0

Email: Ulrike.Herberg@ukb.uni-bonn.de

      >