Intrapericardial teratoma in a twin fetus: Diagnosis and management

BACKGROUND: A rare cause of hydrops fetalis, intrapericardial teratoma is invariably associated with a pericardial effusion. In fetal life, the effusion or mass effect may cause cardiac tamponade, hydrops, and death. After delivery, ventilation and cardiac output may be compromised. CASE: One fetus of twins was diagnosed at 20 weeks' gestation with an intrapericardial teratoma. The affected twin underwent two intrauterine pericardiocentesis and had the tumor resected after delivery at 35 weeks' gestation. One year later, both twins are alive and well and have no evidence of tumor recurrence. CONCLUSION: Pericardiocentesis for tamponade secondary to a fetal intrapericardial teratoma, even when complicating a twin pregnancy, may prevent fetal death and allow delay of delivery until adequate fetal lung maturity has been achieved.