DIAGNOSIS AND MANAGEMENT OF FETAL CARDIAC TUMORS - A MULTICENTER EXPERIENCE AND REVIEW OF PUBLISHED REPORTS

Objectives. We sought to determine the prevalence and natural history of cardiac tumors in patients referred for fetal echocardiography. Bac kground. Cardiac tumors are rare; the prevalence, reported from autops y studies of patients of all ages, varies from 0.0017% to 0.28%. Despi te many case reports, the prevalence and natural history of fetal card iac tumors are unclear. Methods. Fourteen thousand fetal echocardiogra ms recorded over an 8-year period in seven centers were available for retro retrospective review. Medical records and echocardiograms were s tudied led to determine the reason for referral, family history of tub erous sclerosis, prenatal and postnatal course and tumor description a nd type. Results. Cardiac tumors were present in 19 pregnancies (0.14% ). Gestational age at diagnosis ranged from 21 to 38 weeks. The most c ommon indication for referral was a mass on an obstetric ultrasound st udy. The tumors were singular in 10 patients and multiple in 9. Tumor size ranged from 0.4 x 0.4 to 3.5 x 4 cm, and the majority of tumors w ere not hemodynamically significant, There were 17 patients with rhabd omyomas, 1 with a fibroma and I with an atrial hemangioma. Tuberous sc lerosis complex was diagnosed in 10 patients. Partial or complete tumo r regression was seen in eight patients; tumors were unchanged in five ; and three required operation. Conclusions. Fetal cardiac tumors, a r are condition, are often benign. The majority of tumors are rhabdomyom as, but not all fetuses with rhabdomyoma have tuberous sclerosis.