Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2021; 9(17): 4336-4341
Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4336
Primary primitive neuroectodermal tumor in the pericardium—a focus on imaging findings: A case report
Shu-Ming Xu, Juan Bai, Jin-Hua Cai
Shu-Ming Xu, Department of Radiology, Children’s Hospital of Shanxi, Taiyuan 030013, Shanxi Province, China
Juan Bai, Department of Medical Imaging, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Jin-Hua Cai, Department of Radiology, Children’s Hospital, Chongqing Medical University, Chongqing 400014, China
Author contributions: Xu SM and Bai J performed the data analyses and drafted the manuscript; Cai JH helped perform the analysis with constructive discussions and revised the article for important intellectual content.
Supported by Fund Program for the Scientific Activities of Selected Returned Overseas Professionals in Shanxi Province, No. (2016) 97.
Informed consent statement: Informed written consent was obtained from the patient and legal guardian for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Hua Cai, MD, Chief Doctor, Department of Radiology, Children’s Hospital, Chongqing Medical University, No. 136 Zhongshan 2 Road, Yuzhong District, Chongqing 400014, China. cai_jinhua@126.com
Received: January 19, 2021
Peer-review started: January 19, 2021
First decision: February 11, 2021
Revised: February 19, 2021
Accepted: March 15, 2021
Article in press: March 15, 2021
Published online: June 16, 2021
Processing time: 126 Days and 23.5 Hours
Abstract
BACKGROUND

Primitive neuroectodermal tumors (PNETs) are rare, sporadic malignant tumors of the peripheral nervous system, bone, or soft tissues. However, to the best of our knowledge, only three cases of PNET in the pericardium have been reported in the English literature, and their magnetic resonance imaging findings have not previously been described.

CASE SUMMARY

A 3-year-old boy was hospitalized with a 1-wk history of recurrent vomiting and weakness. Detailed history-taking revealed no evidence of heart disease. Computed tomography demonstrated a soft tissue mass in the left pericardial cavity with heterogeneous contrast enhancement. The border between the mass and the heart was poorly defined. Thoracotomy revealed a mass invading the left ventricle, with a high risk of bleeding. The mass was considered inoperable. A biopsy was performed, and the histological and immunohistochemical findings confirmed the diagnosis of primary PNET of the pericardium. The patient received four cycles of standard chemotherapy. Chest magnetic resonance imaging 3 mo after the initiation of chemotherapy revealed that the tumor in the pericardium still existed, but its volume had slightly decreased. The patient was lost to follow-up, and the final outcome was therefore unknown.

CONCLUSION

Medical imaging plays an important role in defining the pericardial origin of PNET and understanding its characteristics. Magnetic resonance imaging can provide more information on the tumor than computed tomography and may thus aid therapeutic planning.

Keywords: Primary primitive neuroectodermal tumors; Pericardium; Tumor; Computed tomography; Magnetic resonance imaging; Case report

Core Tip: Primitive neuroectodermal tumors (PNETs) are rare, high-grade malignant tumors derived from neural crest cells exhibiting neuroectodermal differentiation. Primary PNET in the pericardium is extremely rare. We present the case of a primary pericardial PNET in a 3-year-old boy, with an emphasis on the computed tomography and magnetic resonance imaging findings. This case adds to the literature on pericardial PNET and provides the first report of the magnetic resonance imaging manifestations of this type of tumor.