Successful intrauterine treatment of nonimmune hydrops fetalis due to pericardial tumor

Year 2019, Volume: 32 Issue: 2, 90 - 93, 31.05.2019

Aytul Corbacıoglu Esmer Helen Bornaun İsil Turan Bakırcı

https://doi.org/10.5472/marumj.570917

Abstract

The prenatal diagnosis of pericardial tumor is extremely rare.
It may have serious consequences such as massive pericardial
effusion, cardiac tamponade, hydrops fetalis and fetal demise.
We present a case of nonimmune hydrops fetalis secondary
to pericardial mass which was successfully treated in utero
by serial pericardiocentesis. Also, we present a review of the
literature regarding the intrauterine interventions performed
in pericardial tumor cases. At 24 weeks’ gestation ascites,
diffuse subcutaneous edema at the thorax and abdomen, scalp
edema and two masses within severe pericardial effusion were
detected. After the pericardiocentesis performed at 25, 28 and
29 weeks’ gestation, ascites and scalp edema resolved, and the
pericardial effusion regressed gradually. The size of masses did
not change throughout the gestation. After the infant was born
at 37 weeks’ gestation, the masses shrunk spontaneously within
five months

Keywords

Pericardial tumor, Pericardiocentesis, Intrauterine treatment, Nonimmune hydrops fetalis, Pericardial effusion

References

• 1. Holley DG, Martin GR, Brenner JI. Diagnosis and management of fetal cardiac tumors: a multicenter experience and review of published reports. J Am Coll Cardiol 1995;26:516-20. doi: 10.1016/0735-1097(95)80031-B.
• 2. Isaacs H. Fetal and neonatal cardiac tumors. Pediatr Cardiol 2004;25:252-73. doi:10.1007/s00246.003.0590-4.
• 3. Bruch SW, Adzick NS, Reiss R, et al. Prenatal therapy for pericardial teratomas. J Pediatr Surg 1997;32:1113-5. doi: 10.1016/ S0022-3468(97)90410-3.
• 4. Sklansky M, Greenberg M, Lucas V, et al. Intrapericardial teratoma in a twin fetus: Diagnosis and management. Obstet Gynecol 1997;89:807-9. doi:10.1016/S0029- 7844(97)00031-8.
• 5. Laquay N, Ghazouani S, Vaccaroni L, et al. Intrapericardial teratoma in newborn babies. Eur J Cardiothorac Surg 2003;23:642-44. doi:10.1016/S1010-7940(02)00861-8.
• 6. Tollens T, Casselman F, Devligrt H, et al. Fetal cardiac tamponade due to an intrapericardial teratoma. Ann Thorac Surg 1998;66:559-60. doi:10.1016/S0003-4975(98)00508-6.
• 7. Grebille AG, Mitanchez D, Benachi A, et al. Pericardial teratoma complicated by hydrops: successful fetal therapy by thoracoamniotic shunting. Prenat Diagn 2003,23: 735-9. doi: 10.1002/pd.698.
• 8. Rychik J, Khalek N, Gaynor JW, et al. Fetal intrapericardial teratoma: natural history and management including successful in utero surgery. Am J Obstet Gynecol 2016;215: 780. e1-e7. doi:10.1016/j. ajog.2016.08.010.
• 9. Bader R, Hornberger LK, Nijmeh LJ, et al. Fetal pericardial teratoma: presentation of two cases and review of the literature. Am J Perinatol 2006;23:53-8. doi: 10.1055/s—2005-923433.
• 10. Devliger R, Hindryckx A, Van Miegham T, et al. Therapy for foetal pericardial tumours: Survival following in utero shunting, and literature review. Fetal Diagn Ther 2009;25:407-12. doi:10.1159/000236156.
• 11. Riggs T, Sholl JS, Ilbawi M, et al. In utero diagnosis of pericardial tumor with successful surgical repair. Pediatr Cardiol 1984;5:23-6.
• 12. Paw PT, Jamieson SW. Surgical management of intraperciardial teratoma diagnosed in utero. Ann Thorac Surg 1997;64:552-4. doi:10.1016/S0003-4975(97)00585-7.
• 13. Todros T, Gaglioti P, Presbitero P. Management of a fetus with intrapericardial teratoma diagnosed in utero. J Ultrasound Med 1991;10:287-90. doi: 10.7863/jum.1991.10.5.287.
• 14. Perez-Aytes A, Sanchis N, Barbal A, et al. Non-immunological hydrops fetalis and intrapericardial teratoma: Case report and review. Prenat Diagn 1995;15:859-63. doi:10.1002/ pd.970150912.
• 15. Sepulveda W, Gomez E, Gutierrez J. Intrapericardial teratoma. Ultrasound Obstet Gynecol 2000;15:547-8. doi:10.1046/j.1469-0705.2000.00144.x
• 16. Fujimori K, Honda S, Akutsu H, et al. Prenatal diagnosis of intrapericardial teratoma: a case report. J Obstet Gynaecol Res 1999;25:133-6. doi:10.1111/j.1447-0756.1999.tb01135.x.
• 17. Sydorak RM, Kelly T, Feldstein VA, et al. Prenatal resection of o fetal pericardial teratoma. Fetal Diagn Ther 2002;17:281- 5. doi: 10.1159/000063180.
• 18. Benatar A, Vaughan J, Nicolini U, et al. Prenatal pericardiocenthesis: Its role in the management of intrapericardial teratoma. Obstet Gynecol 1992;79:856-9.
• 19. Thorp JA, Geidt A, Gelatt M, et al. Decompression of fetal cardiac tamponade caused by congenital capillary hemangioma of the pericardium. Obstet Gynecol 2000;96:816-7. doi:10.1016/S0029-7844(00)01045-0.
• 20. Laquay N, Ghazouani S, Vaccaroni L, et al. Intrapericardial teratoma in newborn babies. Eur J Cardiothorac Surg 2003;23:642-4. doi: 10.1016/S1010-7940(02)00861-8.
• 21. Kamil D, Geipel A, Schmitz C, et al. Fetal pericardial teratoma causing cardiac insufficiency: prenatal diagnosis and therapy. Ultrasound Obstet Gynecol 2006;28:972-8. doi: 10.1002/uog.3829.
• 22. Czernik C, Stiller B, Hübler M, et al. Hydrops fetalis caused by a large intrapericardial teratoma. Ultrasound Obstet Gynecol 2006;28:972-8. doi:10.1012/uog.3852.