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.
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 suggests the diagnosis by showing a heterogeneous intrapericardial mass associated with a pericardial effusion compressing the heart.2
Two-dimensional echocardiography is considered to be the best diagnostic imaging modality for primary cardiac tumors, but magnetic resonance imaging may have advantages with large tumors in defining the relationship of the tumor to adjacent structures, in visualizing echocardiographic “blind” spots, and in defining tissue characteristics.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.
- Copyright © 1998 by American Heart Association