Massive pericardial effusion due to intrapericardial mixed germ cell tumor in a premature baby

Abstract

Primary cardiac tumor is uncommon in childhood, with an incidence of 0.06-0.32%, and intrapericardial teratoma represents an exceptional rarity among these entities. Germ cell tumors (GCT) are rare, representing only 1-3% of childhood tumors. Twenty per cent of GCT are malignant and are associated with age and location. Extragonadal involvement accounts for nearly half of the cases. Anterior mediastinum is a common location of malignant germ cell tumors, yet pericardial and aortic adventitia involvement have been rarely reported. Here we report the case of a preterm twin baby boy with intrapericardial mixed germ cell tumor who presented with hydrops fetalis and pericardial effusion.

A rare presentation of extragonadal germ cell tumor; massive pericardial effusion with impending tamponade

“…Tumor rupture can cause pleural or pericardial effusion (14-16) and engage the pericardium. Malignant pericardial effusion is often sporadic and observed in children (8,9,15) and adults (15).…”

“…In cases with anterior mediastinal tumor, the clinical presentation is usually caused by compression on surrounding structures (7). A review of the literature showed that pericardial effusion can rarely be the first manifestation of EGGCT and only few case reports have shown tumoral involvement of pericardium (8)(9)(10)(11), which is more common in children and even premature infants (9).…”

Pericardial effusion as an atypical initial presentation of extra-gonadal nonseminomatous germ cell tumor: a case report and literature review

“…There have been sporadic case reports of a variety of tumors involving the pericardium, most frequently teratomas. After teratomas, a multitude of tumors have been reported to cause pericardial effusions, including paraganglioma, leukemia, schwannoma, carcinoid tumor, primitive neuroectodermal tumor, rhabdoid tumor, pheochromocytoma, melanoma and extragonadal germ cell tumors [ 6 , 9 , 10 ]. It is important to that all of these, including nonseminomatous germ cell tumors, are extremely rare causes of pericardial effusion, with none of these having been shown to cause more than a handful of cases via literature review of case reports, retrospective analyses or meta-analyses.…”

“…Extragonadal seminomatous tumors usually present with an elevated b-HCG and LDH whereas elevations in b-HCG and AFP are commonly seen with extragonadal nonseminomatous neoplasms. Although mediastinal germ cell tumors have been well described, invasion into the pericardium and resultant malignant pericardial effusion is a rare phenomenon which has been the topic of sporadic case reports involving mainly pediatric patients [ 6 , 7 ]. We present a rare care of intrapericardial EGGCT and presented concomitantly with malignant pericardial effusion.…”

Fetal Pericardial Effusion, Cardiac Mass and Coincidental Hypertrophic Cardiomyopathy: A Rare Case Report

“…4 Tedavide her hasta bireysel olarak değerlendirilmekle beraber, semptomatik olanlarda yüksek başarı oranlarıyla cerrahi rezeksiyon önerilmektedir. 7 Tedavi yönetimi gebeliğin gestasyonel evresine ve tümörün histolojisine bağlıdır. Eğer gebeliğin sonlandırılması düşünülüyorsa kitle natürü iyice değerlendirilmelidir.…”