Donald School Journal of Ultrasound in Obstetrics and Gynecology

Register      Login

VOLUME 12 , ISSUE 4 ( October-December, 2018 ) > List of Articles

CASE REPORT

Fetal Mediastinal Mass Associated with Arrhythmia: Artifact and Casual Finding in Ultrasound Diagnosis

Olga Rosales-Aedo, Margarita Alvarez-de-la-Rosa, Ana I Padilla, Juan M Troyano

Keywords : Arrhythmia, Echocardiography, Mediastinum, Prenatal diagnosis, Thymus

Citation Information : Rosales-Aedo O, Alvarez-de-la-Rosa M, Padilla AI, Troyano JM. Fetal Mediastinal Mass Associated with Arrhythmia: Artifact and Casual Finding in Ultrasound Diagnosis. Donald School J Ultrasound Obstet Gynecol 2018; 12 (4):258-261.

DOI: 10.5005/jp-journals-10009-1575

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Aim: We aim to report a case of an enlarged fetal thymus causing arrhythmia. Background: Fetal mediastinal masses may be clinically asymptomatic or cause hemodynamically significant alterations, heart failure, arrhythmias, and sudden cardiac death. Case description: We present a case of fetal mediastinal mass associated with an arrhythmia. A 29-year-old primigravida, with no previous medical history, was referred to our center due to suspicion of fetal arrhythmia detected in a routine control in week 34. A thymus of hyperplasic characteristics was suspected in the ultrasound evaluation. Pregnancy concluded uneventfully with favorable neonatal outcome. Conclusion: The fetal thymus is a structure that usually goes unnoticed during the process of prenatal diagnosis, and when it presents alterations in its morphology, can lead to confusion. Clinical significance: The fetal thymus can be physiologically enlarged and cause fetal arrhythmias without an adverse clinical outcome.


PDF Share
  1. Lele SM, Lele MS, Anderson VM. The thymus in infancy and childhood: embryologic, anatomic, and pathologic considerations. Chest Surg Clin N Am 2001;11:233-253.
  2. Shimosato Y, Mukai K. Tumors of the thymus and related lesions. En: Shimosato Y, Mukai K, eds. Atlas of tumor pathology: tumors of the mediastinum, fasc. 21, ser. 3. Washington, DC: Armed Forces Institute of Pathology, 1997;158-168.
  3. Zalel Y, Gamzu R, Mashiach S, et al. The development of the fetal thymus: an in utero sonographic evaluation. Prenat Diagn 2002;22.
  4. Wacker-Gussmann A, Strasburger JF, Cuneo BF, et al. Fetal arrhythmias associated with cardiac rhabdomyomas. Heart Rhythm. 2014 Apr 1;11(4):677-683.
  5. Dalla Costa M, Mangano FA, Betterle C. Thymic hyperplasia in patients with Graves’ disease. Journal of endocrinological investigation. 2014 Dec 1;37(12):1175-1179.
  6. Ryan AK, Goodship JA, Wilson DI, et al. Spectrum of clinical features associated with interstitial chromosome 22q 11 deletions: a European collaborative study. J Med Genet 1997;34:798-804.
  7. Diemert A, Hartwig I, Pagenkemper M, et al. Fetal thymus size in human pregnancies reveals inverse association with regulatory T cell frequencies in cord blood. Journal of reproductive immunology. 2016 Feb 1;113:76-82.
  8. Felker RE, Caetier MS, Emerson DS, et al. Ultrasound of the fetal thymus. J Ultrasound Med 1989;8:669-673.
  9. Cho JY, Min JY, Lee YH, et al. Diameter of the normal fetal thymus on ultrasound. Ultrasound Obstet Gynecol. 2007;29(6).
  10. De Leon-Luis J, Gámez F, Pintado P, et al. Sonographic measurements of the thymus in male and female fetuses. J Ultrasound Med. 2009;28:43-48..
  11. Yildirim M, Ipek A, Dauletkazin G, et al. Sonographic measurement of the fetal thymus: Relationship with maternal obesity. Journal of Clinical Ultrasound. 2017 Jun;45(5):277-281.
  12. De Leon-Luis J, Pintado P, Gamez F, et al. 720: Ultrasonographic development of the thymus in fetus with Down syndrome: a prospective study. American Journal of Obstetrics and Gynecology [Internet]. Elsevier BV; 2009 Dec;201(6):S260.
  13. Paladini D. How to identify the thymus in the fetus: the thybox. Ultrasound Obstet Gynecol. 2011;37:488-492.
  14. Strasburger J, Cheulkar B, Wichman HJ. Perinatal Arrhythmias: Diagnosis and Management. Clin Perinatol. 2007;34(4): 627.
  15. Rice MJ, McDonald RW, Reller MD. Fetal atrial septal aneurysm: A cause of fetal atrial arrhythmias. J Am Coll Caridiol 1988;12:1292-1297.
  16. Wacker-Gussmann A, Cuneo B, Wakai R, Strasburger J. Diagnosis and Treatment of Fetal Arrhythmia. Am J Perinatol 2014;31:617-628.
  17. Zafar HM, Ankola A, Coleman B. Ultrasound pitfalls and Artifacts Related to Six Common Fetal Findings. Ultrasound Quarterly 2012;28:105-124.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.