Recurrent Cardiac tamponade: intrapericardial teratoma.

88 subcostal retractions were present. Jugular venous pressure and cardiac examination was normal except for the cardiomegaly which was revealed on percussion. Liver was just palpable below the costal margin and was not tender. X-ray chest revealed enlarged cardiac shadow with cardio-thoracic ratio of 0.80 suggestive of pericardial effusion. 2D Echocardiography confirmed the presence of pericardial effusion and also revealed a hyperdense shadow in the region of right atrium suggesting a differential diagnosis of either a neoplasm or hematoma either in or around right atrium. Emergency pericardiocentesis was carried out to relieve the cardiac tamponade. The aspirated pericardial fluid was straw colored transudate with proteins of 3 g/dl and absence of cells suspecting an intrapericardial neoplasm. CT Scan guided biopsy (Fig. 1) of the mass was planned to know the histopathological diagnosis and also to rule out malignancy as cardiac tamponade recurred frequently.