Surgical management of intrapericardial teratoma diagnosed in utero

Intrapericardial teratoma is a rare, often benign congenital tumor, which frequently leads to respiratory distress and pericardial tamponade shortly after birth. Surgical excision is not only curative but potentially lifesaving, because these lesions often become fatal if not promptly excised. We present a case of one of two twins diagnosed with a large intrapericardial teratoma. The management of this case was complicated by the necessity to consider the well-being of the other (normal) twin in planning the timing of delivery and operation. After the twins were delivered by cesarean section in one operating room, the mass was excised from the infant in an adjoining operating room with cardiopulmonary bypass standby.