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F127Prenatal diagnosis of fetal cardiac tumors: 18 cases reported
Author(s) -
Galindo A.,
GutiérrezLarraya F.,
Grañeras A.,
Alvarez C.,
De La Fuente P.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00015-1-126.x
Subject(s) - medicine , tuberous sclerosis , pericardial effusion , fetus , teratoma , gestational age , hemangioma , incidence (geometry) , rhabdomyoma , pregnancy , surgery , radiology , physics , biology , optics , genetics
Aim To evaluate our experience with fetal cardiac tumors. Methods Retrospective study of 18 cases from Jan.1991–Apr.2000, analyzing US features, histology and perinatal outcome. Results The incidence was one in 3224 deliveries (18/58037). Mean gestational age at diagnosis was 32 weeks (22–38). In 17 cases (94%) were isolated while in one the fetus had another defects. In 7 cases (39%) there was one tumor, in 6 two (33%) and in 5 three or more (28%); total number of masses was 42. Size ranged from 2 to 46 mm. In 3 cases (17%) a significant growth of the mass was observed prenatally. Most masses (26) were sited at ventricles (18 left and 8 right). Pericardial effusion was observed in 8 cases (44.4%). In 4 cases there were a significant arrythmia. Histology was available in 7; 5 rhabdomyomas, one cavernous hemangioma and one pericardial teratoma. In the other cases the sonographic appearance was compatible with rhabdomyoma. A postnatal conservative management has been performed in most cases. Overall survival rate was 67% and if top are excluded (2 cases) survival rate rose to 75%. At one year follow‐up, extracardiac manifestations of tuberous sclerosis were diagnosed in 5 cases (28%). In all the 5 cases, there were 2 or more cardiac masses. In 5 of the 11 cases (45%) with more than one tumor, extracardiac manifestations of tuberous sclerosis were observed. Conclusions Fetal cardiac tumors are unfrequent and the diagnosis is usually made in the III trimester. They appear commonly isolated and its size is widely variable; in up to 61% of the cases more than one tumor is observed. Main localization is ventricular and the most common type is rhabdomyoma. A conservative approach is recommended as can behave in a benign fashion. Caution is advocated when counselling families about tuberous sclerosis, mainly if several cardiac masses are detected.