Perinatal diagnosis of cardiac tumors

Objective As fetal cardiac tumors are a rare condition, we report the perin atal diagnosis and ultrasound findings of 12 cases. Methods In 10 cases the tumors were identified prenatally by fetal echocard iography; gestational age at detection ranged from 22 to 34 weeks. In two s ymptomatic infants cardiac tumors were diagnosed on the first day postpartu m; prenatal ultrasound evaluation at 26 and 38 weeks of gestation did not r eveal a cardiac lesion. Results Six fetuses had singular tumors, in six fetuses they were multifoca l. The left ventricle was most often affected. Termination of pregnancy was chosen in three cases, one in association with trisomy 22 and tuberous scl erosis. One intrauterine and three neonatal deaths due to cardiac failure o ccurred. Histopathologic examination revealed cardiac rhabdomyoma in six fe tuses and fibroma in one case. In the five surviving fetuses the size of th e tumors spontaneously decreased postpartum. Rhabdomyomata were associated with tuberous sclerosis in four out of 11 cases. Conclusion Cardiac tumors are detectable as early as 22 weeks of gestation. Presenting symptoms may be arrhythmia, dysfunction of the atrioventricular valves, pericardial effusion and fetal hydrops. The most common perinatal diagnosis is rhabdomyoma, which is often associated with tuberous sclerosis . Sequential examination in high risk patients should be considered as most tumors increase in size during pregnancy and may become evident in late se cond and third trimester of pregnancy. Postpartum, however, regression of t umor size is common.