An intrapericardial mass with features of teratoma as a rare cause of acute coronary syndrome: a case report and 4-year follow-up
M.Z. Gasanov, A.V. Sokolovskaya, A.V. Gasanova, O.E. Kolomatskaya, V.S. Chulkov, V.R. Veber
ABSTRACT. The present clinical case demonstrates a rare variant of acute coronary syndrome, in which the most likely mechanism of myocardial ischemia was extrinsic compression of a coronary artery by an intrapericardial mass with magnetic resonance imaging features of a teratodermoid tumor. A 47-year-old woman was admitted with clinical signs of acute coronary syndrome with ST-segment elevation. Echocardiography revealed regional left ventricular wall motion abnormalities and a mass in the pericardial cavity adjacent to the anterior and anterolateral walls of the left ventricle. Contrast-enhanced cardiac magnetic resonance imaging showed a well-defined heterogeneous mass measuring 33 × 43 × 41 mm with features consistent with a teratodermoid lesion. The differential diagnosis included cardiac and pericardial tumors, metastatic disease, and visceral syphilis. The patient refused biopsy for morphological verification of the mass, as well as surgical treatment. During four years of follow-up, clinical deterioration associated with progression of chronic heart failure was observed. Thus, this case demonstrates a rare “non-classical” cause of the clinical presentation of “classical” acute coronary syndrome and is intended to broaden physicians’ understanding of the etiology of myocardial ischemia.
For citation: Gasanov MZ, Sokolovskaya AV, Gasanova AV, Kolomatskaya OE, Chulkov VS, Veber VR. An intrapericardial mass with features of teratoma as a rare cause of acute coronary syndrome: A case report and 4-year follow-up. Therapy (Moscow). 2026;12(5S):132–137.
https://doi.org/10.18565/therapy.2026.5-s5.132-137
Ключевые слова
acute coronary syndrome
intrapericardial teratoma
teratodermoid mass
extrinsic coronary artery compression
non-atherosclerotic myocardial ischemia
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Об авторах / Для корреспонденции
Mitkhat Z. Gasanov, MD, PhD (Medicine), associate professor of the Department of hospital therapy, deputy director of the Medical Institute, Yaroslav-the-Wise Novgorod State University, Veliky Novgorod, Russian Federation.E-mail: mitkhat.gasanov@novsu.ru
ORCID: https://orcid.org/0000-0001-5856-0404. Scopus ID: 57200421886. eLibrary SPIN: 1236-0012
Anastasia V. Sokolovskaya, MD, cardiologist at the Cardiology Center of the Rostov Regional Clinical Hospital (RRCH No. 1), Rostov-on-Don, Russian Federation.
E-mail: nastyakolos154@yandex.ru
ORCID: https://orcid.org/0009-0002-0132-187X
Anastasiya V. Gasanova, MD, assistant at the Department of hospital therapy of the Medical Institute, Yaroslav-the-Wise Novgorod State University, Veliky Novgorod, Russian Federation.
E-mail: anastasiyaagasanova@gmail.com
ORCID: https://orcid.org/0009-0004-0853-7715. eLibrary SPIN: 5954-4922
Olga E. Kolomatskaya, MD, PhD (Medicine), associate professor of the Department of internal medicine No. 1, Rostov State Medical University, Rostov-on-Don, Russian Federation.
E-mail: okolomackaya@mail.ru
ORCID: https://orcid.org/0000-0003-2888-3194. Scopus ID: 57210175260. eLibrary SPIN: 1185-7348
Vasiliy S. Chulkov, MD, Dr. Sci. (Medicine), professor, head of the Department of hospital therapy, director of the Medical Institute, Yaroslav-the-Wise Novgorod State University, Veliky Novgorod, Russian Federation.
E-mail: vasily.chulkov@novsu.ru
ORCID: https://orcid.org/0000-0002-0952-6856. Scopus ID: 55246314800. eLibrary SPIN: 8001-0051
Viktor R. Veber, MD, Dr. Sci. (Medicine), professor, academician of the Russian Academy of Sciences,head of the Department of Internal medicine, scientific director of the Medical Institute, Yaroslav-the-Wise Novgorod State University, Veliky Novgorod, Russian Federation.
E-mail: viktor.veber@novsu.ru
ORCID: https://orcid.org/0000-0001-7854-0849. Scopus ID: 58378839300. eLibrary SPIN: 8893-1970
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