Abstract
A rare case of a 12-year-old girl with acute cardiac tamponade caused by penetration of a mature mediastinal teratoma into the pericardium is presented. In October 1979 the patient began to suffer from, fever, and dyspnea of more than one month's duration, when an abnormal shadow in the chest X-ray was pointed out by her physician. On the fifth day after admission, she suddenly suffered from severe dyspnea, anterior chest pain, high fever and hypotension. A chest X-ray film at that time showed marked widening of the cardiac silhouette. By echocardiography, cardiac tamponade was detected. As an emergency procedure, pericardiotomy was performed. Over 250ml. of pericardial effusion was removed together with a yellowish necrotic mass, bacterial culture of which yielded staphylococcus aureus. After chemotherapy for one month, she underwent removal of an anterior mediastinal tumor mass by median sternotomy. The tumor mass was a mature teratoma embedded in xanthogranulomatous tissue which was penetrating into the pericardium as well as the left upper lobe of the lung. Microscopically, a certain amount of the pancreatic tissue was found in the teratoma, secretion of digestive juice which was considered to be accountable for the penetration into boths lung and pericardium and also for further infection resulting in cardiac tamponade
