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Fesslova VME, Evangelista M, Piazza L, Saracino A, Andronache A, Chiarello C, Varrica A, Giamberti A, Frigiola A. Regression of Cardiac Rhabdomyomas Producing a Severe Aortic Stenosis: Case Report and Discussion of the Literature. Diagnostics (Basel) 2024; 14:470. [PMID: 38472942 DOI: 10.3390/diagnostics14050470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/23/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
We describe a case of a voluminous rhabdomyoma (R) detected by fetal echocardiography at 32 weeks' gestation (w.g.) obstructing the left ventricular inflow and aortic outflow tract, with a moderate aortic gradient at birth, not needing immediate surgery. At follow-up, the mass progressively regressed, leaving the aortic valve partly damaged, with a gradient that increased to a maximum of 100 mmHg at 9 years. The girl was then operated on successfully by a plasty of the aortic valve. The literature regarding R is discussed.
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Affiliation(s)
- Vlasta M E Fesslova
- Center of Fetal Cardiology, IRCCS Policlinico San Donato, San Donato, 20097 Milan, Italy
| | - Martina Evangelista
- Department of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato, 20097 Milan, Italy
| | - Luciane Piazza
- Department of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato, 20097 Milan, Italy
| | - Antonio Saracino
- Department of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato, 20097 Milan, Italy
| | - Andreea Andronache
- Department of Pediatric and Adult Congenital Cardiology, IRCCS Policlinico San Donato, San Donato, 20097 Milan, Italy
| | - Carmelina Chiarello
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato, 20097 Milan, Italy
| | - Alessandro Varrica
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato, 20097 Milan, Italy
| | - Alessandro Giamberti
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato, 20097 Milan, Italy
| | - Alessandro Frigiola
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato, 20097 Milan, Italy
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Lefizelier E, Benbrik N, Bénéteau C, Le Vaillant C. Cardiac rhabdomyoma with hydrops fetalis: Prenatal management by abdominal drainage. Taiwan J Obstet Gynecol 2021; 60:551-553. [PMID: 33966747 DOI: 10.1016/j.tjog.2021.03.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We described a case of fetal cardiac rhabdomyoma complicated by hydrops. And we discussed our approach during pregnancy. CASE REPORT A 23-year-old woman primigravida was referred at 29 weeks of gestation (WG) to prenatal unit for a large hyperechogenic intracardiac mass associated with fetal hydrops. An intrauterine peritoneo-amniotic shunt was placed. Complete regression of ascites and pericardial effusions were observed after 34 WG with drain in good position. CONCLUSION Cardiac rhabdomyoma is the most common prenatal cardiac tumor. These tumors are benign, asymptomatic and spontaneously regress after birth. However, in some cases, these tumors may cause severe obstructions on the fetal heart and need specific treatment.
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Affiliation(s)
- Emeline Lefizelier
- Department of Obstetrics and Gynecology, CHU Nantes, quai 38 bd Jean Monnet, 44093, Nantes Cedex, France
| | - Nadir Benbrik
- Department of Cardiology Pediatric, CHU Nantes, quai 38 bd Jean Monnet, 44093, Nantes Cedex, France
| | - Claire Bénéteau
- Department of Medical Genetics, CHU Nantes, quai 38 bd Jean Monnet, 44093, Nantes Cedex, France
| | - Claudine Le Vaillant
- Department of Obstetrics and Gynecology, CHU Nantes, quai 38 bd Jean Monnet, 44093, Nantes Cedex, France.
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Frudit P, Vitturi BK, Navarro FC, Rondelli I, Pozzan G. Multiple cardiac rhabdomyomas in tuberous sclerosis complex: case report and review of the literature. AUTOPSY AND CASE REPORTS 2019; 9:e2019125. [PMID: 31641665 PMCID: PMC6771448 DOI: 10.4322/acr.2019.125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 09/04/2019] [Indexed: 11/23/2022] Open
Abstract
Cardiac rhabdomyoma is a benign tumor which constitutes the most common cardiovascular feature of the tuberous sclerosis complex, a multisystem genetically determined neurocutaneous disorder. Cardiac rhabdomyomas can be detected in the prenatal ultrasound, are usually asymptomatic and spontaneously regress within the first three years of life. Less often, the tumors' size, number, and location can produce a mass effect that may lead to blood flow abnormalities or organ dysfunction (heart failure and arrhythmia). In this setting, severe morbidity, and eventually, a lethal outcome despite clinical and surgical treatment may ensue. We describe a fatal case of multiple cardiac rhabdomyomas in a newborn girl. One of the rhabdomyomas was large and unfavorably located, causing significant obstruction of the left ventricular outflow tract. The autopsy identified, in addition to cardiac rhabdomyomas, brain glioneuronal hamartomas (cortical tubers), subependymal nodules and subependymal giant cell tumors, characteristic of the tuberous sclerosis complex. The newborn's family was investigated for the presence of typical clinical symptoms of the complex and image findings showed significant phenotypical variations and a broad symptom spectrum among the family members. This interesting case underscores the variability of tuberous sclerosis complex and the importance of performing a comprehensive postmortem examination in the identification of the cause of death, especially in the setting of familial disease.
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Affiliation(s)
- Paula Frudit
- Santa Casa de São Paulo School of Medical Sciences. São Paulo, SP, Brazil
| | | | - Flavia Cristina Navarro
- Irmandade da Santa Casa de Misericórdia de São Paulo, Department of Pediatrics. São Paulo, SP, Brazil
| | - Ivan Rondelli
- Irmandade da Santa Casa de Misericórdia de São Paulo, Department of Pathology. São Paulo, SP, Brazil
| | - Geanete Pozzan
- Irmandade da Santa Casa de Misericórdia de São Paulo, Department of Pathology. São Paulo, SP, Brazil
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Pruksanusak N, Suntharasaj T, Suwanrath C, Phukaoloun M, Kanjanapradit K. Fetal cardiac rhabdomyoma with hydrops fetalis: report of 2 cases and literature review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:1821-1824. [PMID: 23091254 DOI: 10.7863/jum.2012.31.11.1821] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Rhabdomyoma is the most common cardiac tumor in fetuses, often associated with the tuberous sclerosis complex, especially when multiple tumors and a positive family history of tuberous sclerosis are noted. The tumor is often benign and has a tendency to regress but may increase in size until the early third trimester. Fetal cardiac rhabdomyoma complicated by hydrops fetalis and leading to fetal death is rare. We report 2 cases of fetal cardiac rhabdomyoma with hydrops fetalis and provide a review of the literature.
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Affiliation(s)
- Ninlapa Pruksanusak
- Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand.
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Abstract
Cardiac tumors are rare in neonates, most are benign hamartomas (rhabdomyomas) of the muscle cells. Due of large size, they may cause homodynamic instability and even death in neonatal period. They are rarely diagnosed prenatally and are found in multiple forms. In ∼50% of the cases, rhabdomyoma is associated with tuberous sclerosis.
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Affiliation(s)
- Mukul Aggarwal
- Neonatal Division, Department of Pediatrics, Safdarjang Hospital, New Delhi, India
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Considerations for prenatal counselling of patients with cardiac rhabdomyomas based on their cardiac and neurologic outcomes. Cardiol Young 2010; 20:18-24. [PMID: 20092673 DOI: 10.1017/s1047951109992046] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cardiac rhabdomyomas are benign cardiac tumours with few cardiac complications, but with a known association to tuberous sclerosis that affects the neurologic outcome of the patients. We have analysed the long-term cardiac and neurological outcomes of patients with cardiac rhabdomyomas in order to allow comprehensive prenatal counselling, basing our findings on the records of all patients seen prenatally and postnatally with an echocardiographic diagnosis of cardiac rhabdomyoma encountered from August, 1982, to September, 2007. We analysed factors such as the number and the location of the tumours to establish their association with a diagnosis of tuberous sclerosis, predicting the cardiac and neurologic outcomes for the patients.Cardiac complications include arrhythmias, obstruction of the ventricular outflow tracts, and secondary cardiogenic shock. Arrhythmias were encountered most often during the neonatal period, with supraventricular tachycardia being the commonest rhythm disturbance identified. No specific dimension or location of the cardiac rhabdomyomas predicted the disturbances of rhythm.The importance of the diagnosis of tuberous sclerosis is exemplified by the neurodevelopmental complications, with four-fifths of the patients showing epilepsy, and two-thirds having delayed development. The presence of multiple cardiac tumours suggested a higher risk of being affected by tuberous sclerosis. The tumours generally regress after birth, and cardiac-related problems are rare after the perinatal period. Tuberous sclerosis and the associated neurodevelopmental complications dominate the clinical picture, and should form an important aspect of the prenatal counselling of parents.
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7
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Chao AS, Chao A, Wang TH, Chang YC, Chang YL, Hsieh CC, Lien R, Su WJ. Outcome of antenatally diagnosed cardiac rhabdomyoma: case series and a meta-analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2008; 31:289-295. [PMID: 18307215 DOI: 10.1002/uog.5264] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Rhabdomyoma, the most common primary fetal cardiac tumor, is often associated with tuberous sclerosis (TS). We aimed to evaluate outcome in cases diagnosed with fetal cardiac rhabdomyoma. METHODS This study presents 11 cases with fetal cardiac rhabdomyoma. In addition, all relevant published cases of antenatally diagnosed cardiac rhabdomyoma since 1982 were identified from MEDLINE. We evaluated the following risk factors associated with clinical impact and perinatal outcome: family history of TS, gestational age at diagnosis, tumor size, site and number of tumors, tumor progression, and associated intracardiac and extracardiac anomalies. RESULTS In this meta-analysis, 138 cases, including nine newly added by us, were categorized into Group A (107 live babies) and Group B (16 neonatal deaths and 15 intrauterine fetal deaths). Univariate analysis showed that large cardiac tumors (P < 0.0001), fetal dysrhythmia (P < 0.0001) and hydrops (P < 0.0001) were strong predictors of neonatal outcome. Tumor size >or= 20 mm (relative risk (RR), 20.6; 95% CI, 2.2-195.9; P = 0.009) and fetal dysrhythmia (RR, 13.6; 95% CI, 2.9-62.3; P = 0.001) were significantly associated with neonatal morbidity. TS, present in 85/133 (63.9%) cases, was significantly associated with multiple cardiac tumors (P < 0.0001) and family history of TS (P = 0.02). CONCLUSIONS Large tumor size and hydrops are significantly associated with poor neonatal outcome, whereas family history of TS and multiple fetal cardiac tumors are associated with TS. Any sonographic detection of a fetal cardiac tumor should warrant further investigation for the possible presence of associated disorders.
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Affiliation(s)
- A S Chao
- Department of Obstetrics and Gynecology, Chang-Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan.
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Abstract
Although cardiac tumors are rare, they nevertheless represent an important subgroup, the diagnosis of which is challenging for the primary care physician. Symptoms are not characteristic and serious complications including stroke, myocardial infarction and even sudden death from arrhythmia may be the first signs of tumor. The most common primary cardiac neoplasm is the benign myxoma and the most frequent primary malignant lesion is sarcoma. Cardiac metastases from distant primary carcinomas are now frequently encountered. Echocardiography until the past decade was the only consistently reliable and available non-invasive diagnostic tool. New non-invasive CT and MRI exams are changing the diagnostic approach. Echocardiography and angiocardiography with or without coronary arteriography remain routine methods for evaluating cardiac neoplasms. However, CT provides additional diagnostic information and is regarded as essential for adequate staging and treatment planning, particularly when surgical resection is being considered. This chapter reviews the wide spectrum of intracardiac thrombi and tumors including their incidence and imaging characteristics with particular reference to the CT findings and differential diagnosis.
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Affiliation(s)
- Servet Tatli
- Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
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Abstract
Primary tumors of the heart are uncommon in the fetus and neonate. Nevertheless, the widespread use of new imaging techniques has contributed significantly to earlier diagnosis, treatment, and thus improved survival. The clinical findings, imaging studies, pathology, and outcome of 224 fetuses and neonates with cardiac tumors collected from the literature are evaluated and discussed. Most tumors are benign, and of these rhabdomyoma is the most common, followed by teratoma, fibroma, oncocytic cardiomyopathy, vascular tumors, and myxoma. Malignant and metastatic tumors are described but are rare. Murmurs, arrhythmias, cyanosis, respiratory distress, and cardiac failure are the main presenting signs of cardiac tumors in the perinatal period. Disturbances in hemodynamic function are correlated with the size and location of the tumor. Cardiac vascular tumors have the best outcome, whereas malignant tumors have the worst. The purpose of this review is to concentrate on the fetus and neonate in an attempt to determine the various ways cardiac tumors differ clinically and morphologically in this age group from those occurring in older children and adults and to show that certain types of tumors have a better prognosis than others.
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Affiliation(s)
- H Isaacs
- Department of Pathology, Children's Hospital San Diego, 3020 Children's Way, MC 5007, San Diego, CA 92123, USA.
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Haddour L, Haddour N, Doghmi N, Cherti M, Benmimoun EG, Arharbi M. [Tuberous sclerosis and cardiac tumor (case report)]. Ann Cardiol Angeiol (Paris) 2004; 52:386-8. [PMID: 14752924 DOI: 10.1016/s0003-3928(02)00191-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report the case of a cardiac tumor, which is found in a systematic cardiac examination of an 11 year old girl who had a tuberous sclerosis. The interest of this observation is to show the importance of a general examination, especially cardiac, within this pathology. Tuberous sclerosis is an hereditary disease, associated with rhabdomyomas in 50% of cases or more. Cardiac rhabdomyomas are frequently multiple and detected in utero in some cases. Conversely, 60% of these tumors are seen in a context of tuberous sclerosis. Rhabdomyomas are the most common cardiac tumors of infants and children, the large majority occurring in patients younger than one year and are diagnosed more and more in foetal echocardiography.
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Affiliation(s)
- L Haddour
- Service de cardiologie BCH, 12, rue Cadi Benbrahim Pinede Souissi, Ibn Sina Rabat, Maroc.
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11
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Verhaaren HA, Vanakker O, De Wolf D, Suys B, François K, Matthys D. Left ventricular outflow obstruction in rhabdomyoma of infancy: meta-analysis of the literature. J Pediatr 2003; 143:258-63. [PMID: 12970643 DOI: 10.1067/s0022-3476(03)00250-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Primary heart tumors are exceptional in infants and children. Most common is the rhabdomyoma, often associated with tuberous sclerosis (Bourneville's disease). This tumor is generally believed to have no hemodynamic effects in the majority of cases. Recently, severe obstruction of the left ventricular outflow tract by a solitary tumor was diagnosed during pregnancy and emergency surgery was needed soon after birth.
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Affiliation(s)
- Henri A Verhaaren
- Departments of Pediatrics and Cardiac Surgery, University and University Hospital of Ghent, De Pintelaan 185, B-9000 Ghent, Belgium.
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12
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Perez T, Christiaens L, Bonneau D, Nassimi A, Oriot D. [Cardiac hamartomas in Bourneville's tuberous sclerosis. Perinatal echographic diagnosis and spontaneous evolution]. Arch Pediatr 2003; 10:126-9. [PMID: 12829353 DOI: 10.1016/s0929-693x(03)00308-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED Cardiac hamartomas are frequently the earliest revelation of Bourneville's tuberous sclerosis. They sometimes allow to consider the diagnosis during the antenatal period, and to plan therefore genetic and CNS investigations. After the neonatal period, the evolution of hamartomas is frequently favourable, characterised with at least partial involution. OBSERVATION Antenatal equivocal cardiac echographic images did not allow the diagnosis in a fetus whose father had Bourneville's disease. Other antenatal investigations (genetics, central nervous system MRI) were not helpful. The diagnosis was carried out at birth as cardiac ultrasound reliably showed two cardiac hamartomas. CONCLUSION Even when suspected, the antenatal diagnosis of Bourneville's disease is difficult. The presence of cardiac hamartomas at birth is a reliable mean to make the diagnosis.
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Affiliation(s)
- T Perez
- Service de médecine néonatale, hôpital Gatien-de-Clocheville, 49, boulevard Béranger, 37044 Tours cedex, France.
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Peraira Moral JR, Burgueros Valero M, Rubio Vidal MD, García-Guereta Silva L. Masa intracardíaca en paciente con atresia pulmonar y defecto septal ventricular. An Pediatr (Barc) 2003; 59:401-3. [PMID: 14519310 DOI: 10.1016/s1695-4033(03)78203-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
Rhabdomyomas are not uncommon in infants with tuberous sclerosis. We describe a neonate who presented with hydrops fetalis arising from a tachyarrhythmia during fetal life related to rhabdomyomas. After reversion of the arrhythmia, pre-excitation was noted on an interval electrocardiogram. Following regression of the tumours, the delta wave disappeared with no further arrhythmias noted.
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Affiliation(s)
- C Mas
- Monash University Centre for Heart and Chest Research, Monash Medical Centre, Clayton, Victoria, Australia
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Krapp M, Baschat AA, Gembruch U, Gloeckner K, Schwinger E, Reusche E. Tuberous sclerosis with intracardiac rhabdomyoma in a fetus with trisomy 21: case report and review of literature. Prenat Diagn 1999; 19:610-3. [PMID: 10419607 DOI: 10.1002/(sici)1097-0223(199907)19:7<610::aid-pd596>3.0.co;2-q] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A large cardiac rhabdomyoma protruding into the left ventricle was diagnosed in a fetus at 21+2 weeks of gestation by grey-scale echocardiography. Obstruction to left ventricular outflow was ruled out by colour and spectral Doppler echocardiography. No other abnormalities were noted and karyotyping by cordocentesis revealed trisomy 21 (47,XY,+21). Post-mortem examination after termination of pregnancy confirmed the prenatal diagnosis of cardiac rhabdomyoma and in addition revealed fetal tuberous sclerosis. Demonstration of cardiac rhabdomyoma by prenatal ultrasound should raise suspicion of the presence of fetal tuberous sclerosis. Despite the incidental association with aneuploidy, fetal karyotyping is suggested for optimal counselling of parents.
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Affiliation(s)
- M Krapp
- Division of Prenatal Medicine, Department of Obstetrics and Gynaecology, Medical University of Lübeck, Germany
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Werner H, Mirlesse V, Jacquemard F, Sonigo P, Delezoide AL, Gonzales M, Brunelle F, Fermont L, Daffos F. Prenatal diagnosis of tuberous sclerosis. Use of magnetic resonance imaging and its implications for prognosis. Prenat Diagn 1994; 14:1151-4. [PMID: 7899282 DOI: 10.1002/pd.1970141208] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Tuberous sclerosis (TS) is an autosomal dominant disorder with a high rate of de novo mutation. The real difficulty is to ascertain the diagnosis and to give the neurological prognosis in each case. Prenatal diagnosis of TS is generally based on ultrasonographic signs of multiple cardiac tumours, i.e. rhabdomyomas. Recent progress in magnetic resonance imaging (MRI) enables the diagnosis in a large proportion of cases based on typical brain lesions. It may have a role in the prenatal management of TS, although MRI images seem to underestimate the anatomical findings. Two cases in which TS was diagnosed prenatally are presented with reference to the value of MRI in the prenatal management and comparison with anatomical findings.
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Affiliation(s)
- H Werner
- Service de Médecine et Biologie Foetale, Institut de Puériculture, Paris, France
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Butto F, Ben Shachar G, Najmabadi H, Smith G. Massive cardiac tumor presenting as severe cyanosis in a newborn. Pediatr Cardiol 1994; 15:103-4. [PMID: 7997411 DOI: 10.1007/bf00817619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Abstract
Three cases of intracardiac rhabdomyomas in neonates are presented. All were diagnosed by ultrasound, one prenatally and two directly after birth. Two of the patients were operated on during the neonatal period. The operations were carried out on the ultrasound findings alone. One patient was considered inoperable and died at three weeks of age. The two surviving patients have no cardiac symptoms and involution of the tumors has taken place. Two of the three patients have shown signs of tuberous sclerosis.
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Affiliation(s)
- G Björkhem
- Department of Pediatrics, University Hospital, Lund, Sweden
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19
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Wheller JJ, Cordier JM, Allen HD. In Utero Diagnosis of Multiple Intracardiac Tumors. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 1991. [DOI: 10.1177/875647939100700105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Obstetric ultrasound evaluation of the fetus should include routine imaging of the heart. The four-chamber view provides valuable information regarding the presence or absence of structural heart disease.' Fetal heart rate and rhythm are also studied as a routine part of the obstetric scan. Thus, dysrhythmias can be evaluated accurately. The finding of unsustained fetal atrial dysrhythmia is common and usually not associated with structural heart disease.2,3 This case report describes the ultrasound evaluation of a fetus with multiple intracardiac rhabdomyomas and an unsustained asymptomatic atrial dysrhythmia. This case emphasizes the importance of the basic four-chamber fetal cardiac view when scanning the fetal heart.
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Affiliation(s)
- John J. Wheller
- Division of Pediatric Cardiology, The Ohio State University College of Medicine, and Columbus Children's Hospital; Division of Cardiology, Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205
| | | | - Hugh D. Allen
- Division of Pediatric Cardiology, The Ohio State University College of Medicine, and Columbus Children's Hospital
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20
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Harding CO, Pagon RA. Incidence of tuberous sclerosis in patients with cardiac rhabdomyoma. AMERICAN JOURNAL OF MEDICAL GENETICS 1990; 37:443-6. [PMID: 2260584 DOI: 10.1002/ajmg.1320370402] [Citation(s) in RCA: 106] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cardiac rhabdomyoma, a rare benign tumor often detected in infancy, is frequently associated with tuberous sclerosis. This association is commonly stated to occur in 50% of all cases of cardiac rhabdomyoma. Recently at our institution, the prenatal detection of a cardiac rhabdomyoma in a fetus at no known risk for tuberous sclerosis emphasized the need to determine the frequency of association in order to provide accurate diagnosis and counseling in such situations. After a review of reported cases and review of patients from our institution diagnosed to have cardiac rhabdomyoma, we estimate that 51-86% of cardiac rhabdomyomas are associated with tuberous sclerosis. We present the results of our literature and case review.
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Affiliation(s)
- C O Harding
- Department of Pediatrics, University of Washington School of Medicine, Seattle
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21
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Machin GA. Hydrops revisited: literature review of 1,414 cases published in the 1980s. AMERICAN JOURNAL OF MEDICAL GENETICS 1989; 34:366-90. [PMID: 2688420 DOI: 10.1002/ajmg.1320340313] [Citation(s) in RCA: 202] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This paper reviews 47 series of hydrops fetalis (804 cases) and 610 individual cases published since 1980. From this large number of cases, guidelines are derived for prenatal diagnosis and management.
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Affiliation(s)
- G A Machin
- Department of Pathology, University of Alberta Hospital, Edmonton, Canada
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