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Fetal Mouse Cardiovascular Imaging Using a High-frequency Ultrasound (30/45MHZ) System
Published on: May 5, 2018
Fetal cardiac tumors: a single-center experience of 40 cases
Yoav Yinon1, David Chitayat, Susan Blaser
1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Canada.
Insights
Fetal cardiac tumors like rhabdomyomas often have a good perinatal outcome, but tuberous sclerosis impacts long-term prognosis. Hydrops and tumor size predict fetal cardiac tumor outcomes.
Area of Science:
- Cardiology
- Fetal Medicine
- Pediatric Oncology
Background:
- Fetal cardiac tumors are rare but can significantly impact pregnancy and neonatal outcomes.
- Understanding their natural history is crucial for prenatal counseling and management.
Purpose of the Study:
- To investigate the natural history and outcomes of prenatally detected fetal cardiac tumors.
- To identify factors influencing survival and long-term prognosis.
Main Methods:
- Retrospective cohort study.
- Analysis of prenatally detected cardiac tumors at a tertiary cardiac care center.
- Review of associated conditions like hydrops, obstruction, and arrhythmia.
Main Results:
- Forty fetuses had cardiac tumors, often associated with hydrops, obstruction, or arrhythmia.
- Rhabdomyomas had a 79% survival rate, but 88% developed tuberous sclerosis.
- Teratomas were universally fatal, while fibromas were associated with survival and normal physiology.
- Fetal or neonatal death correlated with earlier diagnosis, delivery, larger tumor size, and hydrops.
Conclusions:
- Tumor etiology, size, and presence of hydrops are key predictors of fetal cardiac tumor outcomes.
- While rhabdomyomas may have a benign perinatal course, neurological complications of tuberous sclerosis significantly affect long-term prognosis.
Objective:
To determine the natural history and outcome of fetal cardiac tumors.
Methods:
This was a retrospective cohort study of all prenatally detected cases of cardiac tumors at a tertiary cardiac care center.
Results:
Forty fetuses were identified to have one or several cardiac tumors in association with fetal hydrops (18%), ventricular obstruction (30%) and/or arrhythmia (13%). Of 33 cases with rhabdomyoma, three patients elected to terminate the pregnancy, four offspring died at birth and 26 (79%) survived. On follow-up, 95% of all live-born cases with rhabdomyomas were free of cardiac symptoms but 88% had tuberous sclerosis. All three fetuses with teratoma presented with hydrops and none of them survived. In contrast, all three fetuses with cardiac fibroma are alive and have a biventricular physiology. One fetus with a large atrial hemangioendothelioma died in early infancy. Fetal or neonatal death was associated with an earlier cardiac anomaly diagnosis, earlier delivery, larger tumor size and fetal hydrops at presentation.
Conclusions:
The outcome of fetal cardiac tumors was predicted by the etiology and size of the cardiac mass and the presence of hydrops. Although most cardiac rhabdomyomas have a relatively benign perinatal course, the long-term prognosis is determined by the neurological manifestations associated with tuberous sclerosis.
