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  2. Keyword: Prenatal Diagnosis
Figure 1
ABCIC
Case Report

Fetal Intrapericardial Teratoma: Diagnostic and Therapeutic Challenges

Marcia Ferreira Alves Barberato et al. Rodrigo Ferreira Alves Barberato Fernanda Ferreira Alves Barberato Silvio Henrique Barberato

Introduction

Primary cardiac tumors are rare in all age groups, with an incidence of 0.002% to 0.3% in autopsy series. During the prenatal period, cardiac tumors are highly uncommon and may be incidental findings in routine ultrasound assessment, which has become more frequent with the widespread use of imaging methods in the last decades. Fetal echocardiography is the main tool for detailed diagnosis of cardiac anatomy and function from the end of the first trimester until term., During fetal life, the most frequently found tumors are benign primary tumors, which include rhabdomyomas (the most common), as well as teratomas, fibromas, hemangiomas, and myxomas. The finding of malignant primary tumors (for example, rhabdomyosarcoma and fibrosarcoma) or metastatic tumors is exceptionally rare. In fetuses, cardiac tumors can be asymptomatic or lead to complications, such as arrhythmias, hydrops, obstruction of ventricular inflow or outflow, heart failure, and death.

Teratomas, although they are usually benign, can have embryonic origin in one or more of the 3 germ layers, resulting in complex histology, with the possibility of simultaneous areas of mature and immature tissue. Intrapericardial teratomas are tumors with a low incidence, but they frequently invade the mediastinum and compress adjacent structures, leading to death. We report a case of intrapericardial teratoma diagnosed in a fetus at 22 weeks of gestation.

[…]

  • Echocardiography
  • Pericardial Effusion
  • Prenatal Diagnosis
  • Teratoma
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Creative Commons Attribution (CC BY) Creative Commons license
27/08/2024 DOI: 10.36660/abcimg.20240065i Views 1
Perinatal Results and Long-Term Follow-Up of Fetal Cardiac Tumors: A 30-Year Historical Cohort Study
ABC
Original Article

Perinatal Results and Long-Term Follow-Up of Fetal Cardiac Tumors: A 30-Year Historical Cohort Study

Fabricio Marcondes Camargo et al. Maria de Lourdes Brizot Rossana Pulcineli Vieira Francisco Werther Brunow de Carvalho … Nana Miura Ikari Stella Verzinhasse Peres Marco Antônio Borges Lopes Lilian Maria Lopes

Abstract

Background:

This was a 30-year retrospective cohort study that approximates closely to the natural history of cardiac tumors diagnosed in the fetus, since there was no case of pregnancy interruption

Objective:

To assess morbidity and mortality in the perinatal period and at long term in fetuses diagnosed with cardiac tumor. Our secondary objective was to assess the evaluating factors of perinatal and postnatal results.

Methods:

This was a retrospective cohort study with 74 pregnant women with an echocardiographic diagnosis of fetal cardiac tumor at two referral centers between May 1991 and November 2021. A descriptive analysis was performed, and data were expressed as absolute (n) and relative (%) frequencies, median and interquartile range. Fisher’s exact test was used to evaluate the association of echocardiographic characteristics and clinical manifestations with perinatal and postnatal results. Global survival was calculated using the Kaplan-Meier method and the curves were compared by the log-rank test. The time of follow-up, calculated in months, corresponded to the time elapsed from hospital discharge to current status (survived/ censoring or death). The level of significance was set at 5% (p<0.05).

Results:

Rhabdomyoma is the most common type of cardiac tumor (85%), with a high morbidity (79.3%) and overall mortality of 17.4%. The presence of fetal hydrops was a predictor of death.

Conclusion:

The presence of fetal hydrops had an impact on mortality, and hence is an important factor in counselling and determining the prognosis. Most deaths occurred before hospital discharge.

  • Echocardiography
  • Heart Neoplasms
  • Prenatal Diagnosis
  • Rhabdomyoma
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Creative Commons Attribution (CC BY) Creative Commons license
22/03/2024 DOI: 10.36660/abc.20220469 Views 2
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Prenatal Diagnosis of Circular Shunt: A Rare Complication of Ebstein’s Anomaly

Marcia Ferreira Alves Barberato et al. Silvio Henrique Barberato

Circular shunt is a condition in which blood from a cardiac chamber is diverted through the heart to return to the original chamber without reaching the pulmonary capillary bed. A 27-year-old pregnant woman, G1, P0, A0, 25 gestational weeks, was referred for fetal echocardiography due to an increased cardiac area on morphological obstetric ultrasound in the second trimester. She had no comorbidities, and early pregnancy ultrasound findings were normal.

A 25-week fetal echocardiogram showed cardiomegaly, attachment of the tricuspid valve septal leaflet to the interventricular septum, and significant tricuspid insufficiency compatible with Ebstein’s anomaly (). A small pericardial effusion was seen and Huhta cardiovascular score was 6. An adequate pulmonary artery diameter (Z-score 1.9) was noted () with no anterograde flow, only retrograde flow coming from the ductus arteriosus characteristic of a circular shunt. At 29 gestational weeks, fetal hydrops was observed, with zero umbilical artery diastolic flow and a Huhta score of 4 (). Fetal death occurred at 30 gestational weeks.

[…]

  • Ebstein’s Anomaly
  • Echocardiography, Doppler
  • Prenatal Diagnosis
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Creative Commons Attribution (CC BY) Creative Commons license
25/03/2022 DOI: 10.47593/2675-312X/20213404eabc262 Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Barberato MFA, Barberato RFA, Barberato FFA, Barberato SH. Fetal Intrapericardial Teratoma: Diagnostic and Therapeutic Challenges. ABC Imagem Cardiovascular 2024;37(3):e20240065.

Electronic Document Format (ABNT)

Barberato, Marcia Ferreira Alves; Barberato, Rodrigo Ferreira Alves; Barberato, Fernanda Ferreira Alves; Barberato, Silvio Henrique. Fetal Intrapericardial Teratoma: Diagnostic and Therapeutic Challenges. ABC Imagem Cardiovascular, v. 37, n. 3, e20240065, Aug. 2024.

Electronic Document Format (APA)

Barberato, M. F. A., Barberato, R. F. A., Barberato, F. F. A., & Barberato, S. H. (2024). Fetal Intrapericardial Teratoma: Diagnostic and Therapeutic Challenges. ABC Imagem Cardiovascular, 37(3), e20240065.

Electronic Document Format (ISO)

Barberato, Marcia Ferreira Alves and Barberato, Rodrigo Ferreira Alves and Barberato, Fernanda Ferreira Alves and Barberato, Silvio Henrique. Fetal Intrapericardial Teratoma: Diagnostic and Therapeutic Challenges. ABC Imagem Cardiovascular [online]. 2024, vol. 37, n. 3, [cited 2026-10-14], e20240065. Available from: <https://journals.cardiol.br/en/article/fetal-intrapericardial-teratoma-diagnostic-and-therapeutic-challenges/>. ISSN 2318-8219

EndNote RIS

Electronic Document Format (Vancouver)

Camargo FM, Brizot ML, Francisco RPV, Carvalho WB, Ikari NM, Peres SV, Lopes MAB, et al. Perinatal Results and Long-Term Follow-Up of Fetal Cardiac Tumors: A 30-Year Historical Cohort Study. Arquivos Brasileiros de Cardiologia 2024;121(1):e20220469.

Electronic Document Format (ABNT)

Camargo, Fabricio Marcondes; Brizot, Maria de Lourdes; Francisco, Rossana Pulcineli Vieira; Carvalho, Werther Brunow de; Ikari, Nana Miura; Peres, Stella Verzinhasse; Lopes, Marco Antônio Borges; Lopes, Lilian Maria. Perinatal Results and Long-Term Follow-Up of Fetal Cardiac Tumors: A 30-Year Historical Cohort Study. Arquivos Brasileiros de Cardiologia, v. 121, n. 1, e20220469, Mar. 2024.

Electronic Document Format (APA)

Camargo, F. M., Brizot, M. L., Francisco, R. P. V., Carvalho, W. B. , Ikari, N. M., Peres, S. V., Lopes, M. A. B., & Lopes, L. M. (2024). Perinatal Results and Long-Term Follow-Up of Fetal Cardiac Tumors: A 30-Year Historical Cohort Study. Arquivos Brasileiros de Cardiologia, 121(1), e20220469.

Electronic Document Format (ISO)

Camargo, Fabricio Marcondes and Brizot, Maria de Lourdes and Francisco, Rossana Pulcineli Vieira and Carvalho, Werther Brunow de and Ikari, Nana Miura and Peres, Stella Verzinhasse and Lopes, Marco Antônio Borges and Lopes, Lilian Maria. Perinatal Results and Long-Term Follow-Up of Fetal Cardiac Tumors: A 30-Year Historical Cohort Study. Arquivos Brasileiros de Cardiologia [online]. 2024, vol. 121, n. 1, [cited 2026-10-14], e20220469. Available from: <https://journals.cardiol.br/en/article/perinatal-results-and-long-term-follow-up-of-fetal-cardiac-tumors-a-30-year-historical-cohort-study/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Barberato MFA, Barberato SH. Prenatal Diagnosis of Circular Shunt: A Rare Complication of Ebstein’s Anomaly. Arquivos Brasileiros de Cardiologia Imagem cardiovascular 2022;34(4):eabc262.

Electronic Document Format (ABNT)

Barberato, Marcia Ferreira Alves; Barberato, Silvio Henrique. Prenatal Diagnosis of Circular Shunt: A Rare Complication of Ebstein’s Anomaly. Arquivos Brasileiros de Cardiologia Imagem cardiovascular, v. 34, n. 4, eabc262, Mar. 2022.

Electronic Document Format (APA)

Barberato, M. F. A., & Barberato, S. H. (2022). Prenatal Diagnosis of Circular Shunt: A Rare Complication of Ebstein’s Anomaly. Arquivos Brasileiros de Cardiologia Imagem cardiovascular, 34(4), eabc262.

Electronic Document Format (ISO)

Barberato, Marcia Ferreira Alves and Barberato, Silvio Henrique. Prenatal Diagnosis of Circular Shunt: A Rare Complication of Ebstein’s Anomaly. Arquivos Brasileiros de Cardiologia Imagem cardiovascular [online]. 2022, vol. 34, n. 4, [cited 2026-10-14], eabc262. Available from: <https://journals.cardiol.br/en/article/prenatal-diagnosis-of-circular-shunt-a-rare-complication-of-ebsteins-anomaly/>. ISSN 2318-8219

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