EARLY SONOGRAPHIC DIAGNOSIS OF INTRAPERICARDIAL TERATOMA

An intrapericardial teratoma associated with a large pleural effusion and elevated aortic outflow velocity was diagnosed at 23.6 weeks' gest ation. Less than 4 weeks earlier, an obstetric scan, including a four- chamber heart view, had been normal In less than a week following diag nosis, fetal hydrops and bradycardia developed. 'Heroic' pericardiocen tesis was declined by the patient, and the fetus died. This case demon strates the potential for rapid growth in pericardial teratomas, and i llustrates the possibility of anticipating fetal compromise from tumor mass effect, when intracardiac Doppler studies are abnormal. Implicat ions for management of these rave tumors, and specifically for the hyp othetical role of fetal surgery are discussed.