Prenatal and postnatal imaging of an intrapericardial teratoma

Intrapericardial teratomas are rare tumors arising from all three germinal layers. They are mostly benign but can lead to life-threatening complications. A 38-year-old woman with an in vitro fertilization (IVF) conception had a normal fetal anatomical survey at 20 weeks of gestation. At 32 weeks, during evaluation for decreased fetal movements and gestational diabetes, the fetus was found to have a unilateral right pleural effusion, a large pericardial effusion with an 18 × 16 × 17 mm-sized cystic intrapericardial mass and ventricular dysfunction with associated, significant, polyhydramnios. Echocardiography was suggestive of a teratoma which was confirmed by pathology after postnatal surgery. Early prenatal diagnosis and appropriate monitoring during pregnancy are important to optimize outcome, however, even though antenatal intervention may improve the outcome in cases with hydrops, in utero mortality remains high.