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Prenatal ultrasound images. (A) At 26 weeks of gestation, a mixed mass (M) in the pericardium of the fetus with size approximately 27 x 26 mm with pericardial effusion is demonstrated. (B) At 37 weeks of gestation, a slightly strong echo mass (m) can be seen in the right pericardial cavity, with a range of approximately 37 x 36 mm. M/m, mass; RA/ra, right atrium; RV/rv, right ventricle; LA/La, left atrium; LV/Lv, left ventricle.
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F1
Four-dimensional ultrasound at 26 weeks of gestation revealed a mixed mass in the pericardium of the fetus with pericardial effusion (Figure 1).
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Postnatal ultrasound images. (A) The mass (MASS) is close to the ascending aorta (AO), and the boundary is not clear. (B) The mass compresses the ascending aorta, and the velocity in the ascending aorta reaches approximately 2.8 m/s.
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F2
Transthoracic echocardiography (TTE) showed a slightly hyperechoic mass in the right pericardial cavity, approximately 40 x 37 mm in size (Figure 2).
Cardiac computed tomography angiography images. (A, B) Three-dimensional modeling images show a huge mass in the right front of the heart, which severely compresses the ascending aorta and right atrium. (C) The aorta (red arrow) is compressed and flattened by the mass. (D) The mass compresses the right atrium.
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F3
For better evaluation and confirmation of the diagnosis, cardiac computed tomography angiography (CTA) was performed, and a slightly low-density mass was seen outside the right atrium, with a size of approximately 44.3 x 39.2 x 42.3 mm (Figure 3).
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Intraoperative view. (A) The appearance of a mass after thoracotomy; (B) the appearance of a partially free mass placed outside the thoracic cavity; and (C) polycystic fat in the cross section after dissection of the mass.
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F4
The mass had displaced the heart to the left, and the superior vena cava was compressed and posteriorly displaced (Figure 4).
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