Successful surgical treatment of a 1160 g neonate with cardiac teratoma and severe foetal hydrops: a case report

BACKGROUND: Prenatally diagnosed pericardial teratoma present a rare finding with an unfavourable prognosis due to frequently associated Foetal hydrops and limited treatment options. We report a successful surgical resection of a prenatally diagnosed cardiac teratoma in a 1160 g neonate with severe Foetal hydrops and cardiac deterioration. CASE SUMMARY: The patient was transferred in utero to our institution due to prior diagnosed pericardial mass and severe foetal hydrops, which necessitated caesarean section one day after arrival at a gestational age of 28 + 0 weeks. After intubation, the patient was stabilized by surgical drainage of 60 mL of pericardial effusion. Further clinical worsening of the patient on the day of life 12 demanded urgent intervention, so that in toto resection of the tumour was performed at a bodyweight of 1160 g. Histopathological analysis revealed a teratoma and the patient is in excellent clinical condition one year after surgery. DISCUSSION: This case report demonstrates that an interdisciplinary, two-staged approach can be a feasible and promising treatment option in patients with prenatally diagnosed teratoma and severe Foetal hydrops in a critical circulatory state. Furthermore, it illustrated that resection of pericardial masses can be successfully performed at a bodyweight as low as 1160 g.