A THREE-DAY OLD NEONATE WITH INTRAPERICARDIAL IMMATURE TERATOMA AND CARDIAC TAMPONADE

Intrapericardial immature teratoma is a rare, primary cardiac tumor that often
causes symptoms through pressure on the structures of the cardiovascular and/or respiratory system
and can potentially be fatal. Immature teratoma has the potential to be malignant.
Case Report: The patient was a three-day old term male neonate that was admitted in neonatal ICU
due to respiratory distress. The neonate had tachypnea (RR>55/min), tachycardia (HR>170/min) and
weak pulses. Echocardiography showed massive pericardial effusion and a large capsulated multicystic, fluid filled lesions on the anterior of the heart which was pressing on the right atrium and right
ventricle. Chest CT scan confirmed echocardiographic findings. The baby emergently was referred for
cardiac surgery and the tumor was successfully removed. Histopathologic report of tumor was
immature teratoma grade I. The postoperative course was uneventful and one year later in outpatient
follow up the infant showed normal development and normal echocardiogram and had no evidence of
tumor relapse.
Conclusion: Intrapericardial immature teratoma with massive effusion can cause tamponade in early
days of life. Early cardiac surgery is life saving. These tumors are surgically respectable. Immature
teratoma has the potential to be malignant, but in this case which was screened regularly every two
months with serum FTP, LDH and HCG levels, echocardiography and chest CT scan, there were no
signs of metastasis six months after operation