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 multi-cystic, 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. 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.