title: Prenatal resection of a fetal pericardial teratoma.
abstract: OBJECTIVE
  Pericardial teratomas are rare congenital tumors which invade the developing mediastinum, compressing the venous return to the heart, leading to hydrops. Tumors, with large cystic components, have been treated previously with in utero pericardiocentesis with some success. We present the first reported case of in utero open resection of a fetal pericardial teratoma.
  
  
  METHODS
  A 31-year-old G1P0 woman was found to have a fetus with a pericardial teratoma. Hydrops developed at 24 weeks' gestation. After counseling, open fetal resection was performed via a fetal median sternotomy.
  
  
  RESULTS
  Although the tumor was successfully removed, the hydrops did not resolve. In addition, over the course of 3 weeks, the mother developed maternal mirror syndrome which prompted an emergent cesarean section. Neonatal death ensued shortly after birth.
  
  
  CONCLUSIONS
  The fetus with a pericardial teratoma complicated by hydrops is compromised. Treatment options include early delivery, aspiration of the pericardial effusion, and in utero operative resection.
authors.affiliation: The Fetal Treatment Center, University of California, San Francisco, Calif. 94143-0570, USA.
authors.forename: Roman M
authors.initials: RM
authors.lastname: Sydorak
authors.forename: Thomas
authors.initials: T
authors.lastname: Kelly
authors.forename: Vickie A
authors.initials: VA
authors.lastname: Feldstein
authors.forename: Per L
authors.initials: PL
authors.lastname: Sandberg
authors.forename: Norman H
authors.initials: NH
authors.lastname: Silverman
authors.forename: Michael R
authors.initials: MR
authors.lastname: Harrison
authors.forename: Craig T
authors.initials: CT
authors.lastname: Albanese
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D005333:Fetus / Q000601:surgery*; D006338:Heart Neoplasms / Q000151:congenital / Q000601:surgery*; D006801:Humans; D015160:Hydrops Fetalis / Q000150:complications; D010496:Pericardium / Q000601:surgery*; D011247:Pregnancy; D013724:Teratoma / Q000151:congenital / Q000601:surgery*