Alkheder Ahmad, Fathallah Ibrahim, Alajrd Abd Alrhman, Al-Talep Ahmed, Alsodi Zeina, Takkem Saleh
Department of Otorhinolaryngology, Al Mouwasat University Hospital, Faculty of Medicine, Damascus University, Damascus, Syria; Faculty of Medicine, Syrian Private University, Damascus, Syria; Faculty of Medicine, Damascus University, Damascus, Syria.
Faculty of Medicine, Al-Baath University, Homs, Syria.
Int J Surg Case Rep. 2024 Nov;124:110448. doi: 10.1016/j.ijscr.2024.110448. Epub 2024 Oct 12.
Teratomas are neoplasms originating from embryonic tissues, characterized by a diverse composition of cells from all three germ layers in varying ratios. Rarely reported in the heart, we present here a rare case of a teratoma in the right atrium of a newborn.
A 20-h-old newborn was referred for a mild heart murmur. An echocardiogram revealed a 6 × 9 mm mass in the right atrium, attached to the interatrial septum. The mass caused mild tricuspid regurgitation without any significant pressure gradient. Surgery to remove the mass was successful. Pathological examination confirmed the mass as a teratoma. The child was discharged in excellent health and has had normal follow-up exams.
Mature teratomas, a common type of germ cell tumor, are rare in the mediastinum, accounting for 10-15 % of mediastinal masses. These tumors arise from displaced primordial germ cells, which may become malignant. They can metastasize to the heart via various routes, causing symptoms like cough, dyspnea, and chest pain due to compression of mediastinal structures. Severe cases may lead to superior vena cava syndrome or hemoptysis. Tumor location influences clinical presentation, with some posing life-threatening risks.
Early diagnosis and intervention were crucial in preventing severe complications. This case emphasizes the importance of vigilant clinical evaluation and timely surgical management for infants presenting with cardiac symptoms.
畸胎瘤是起源于胚胎组织的肿瘤，其特征是来自所有三个胚层的细胞以不同比例组成。心脏畸胎瘤鲜有报道，在此我们呈现一例新生儿右心房畸胎瘤的罕见病例。
一名20小时大的新生儿因轻度心脏杂音前来就诊。超声心动图显示右心房有一个6×9毫米的肿块，附着于房间隔。该肿块导致轻度三尖瓣反流，无明显压力梯度。手术切除肿块成功。病理检查证实该肿块为畸胎瘤。患儿健康出院，随访检查正常。
成熟畸胎瘤是一种常见的生殖细胞肿瘤，在纵隔中罕见，占纵隔肿块的10 - 15%。这些肿瘤起源于移位的原始生殖细胞，可能会恶变。它们可通过各种途径转移至心脏，因纵隔结构受压而引起咳嗽、呼吸困难和胸痛等症状。严重病例可能导致上腔静脉综合征或咯血。肿瘤位置影响临床表现，一些病例存在危及生命的风险。
早期诊断和干预对于预防严重并发症至关重要。本病例强调了对出现心脏症状的婴儿进行警惕的临床评估和及时手术治疗的重要性。
