title: Massive pericardial effusion and multiple pericardial masses due to an anterior mediastinal teratoma rupturing in pericardial sac.
abstract: A 25 -year-old Egyptian man presented to our unit for the evaluation of a large pericardial effusion. At 1 month before presentation he suffered from daily bouts of fever. Chest x-ray revealed cardiomegaly, echocardiography showed large pericardial effusion and multiple pericardial masses. Needle pericardiocentesis revealed a bloody exudate with no malignant cells. Chest CT showed a well-circumscribed anterior mediastinal cystic mass with a central fat component and foci of calcification. MRI of the chest similarly showed no intracardiac extension. A cystic mass 7×9 cm was removed via a median sternotomy with uneventful postoperative course. Pathological evaluation revealed a benign cystic teratoma and a thymic cyst. Most cystic teratomas are accidentally discovered, large ones can cause symptoms through the compression of mediastinal structures or rupture in pericardial sac.
authors.affiliation: Department of Cardiothoracic Surgery, Kasr Elaini Hospital, Cairo University, Cairo, Egypt.
authors.forename: Mohammed Abd Elalim
authors.initials: MA
authors.lastname: Ahmed
authors.forename: Ragai
authors.initials: R
authors.lastname: Fouda
authors.forename: Hussam
authors.initials: H
authors.lastname: Ammar
authors.forename: Samy M
authors.initials: SM
authors.lastname: Amin
mesh_terms: D000328:Adult; D002118:Calcium / Q000378:metabolism; D006332:Cardiomegaly / Q000209:etiology; D006801:Humans; D008297:Male; D008476:Mediastinal Cyst / Q000150:complications / Q000473:pathology / Q000601:surgery; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008482:Mediastinum / Q000473:pathology* / Q000601:surgery; D010490:Pericardial Effusion / Q000209:etiology* / Q000601:surgery; D010496:Pericardium / Q000473:pathology* / Q000601:surgery; D012422:Rupture, Spontaneous; D056346:Sternotomy; D013724:Teratoma / Q000150:complications* / Q000473:pathology / Q000601:surgery
chemical_list: D002118:Calcium