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Tuberous sclerosis presenting with fetal and neonatal cardiac tumours

G Wallace1, H C Smith, G H Watson

  • 1Royal Manchester Children's Hospital, Pendlebury.

Insights

Cardiac tumors in infants are often linked to tuberous sclerosis. Hypomelanotic macules, a key sign, may not appear until age two, impacting early diagnosis.

Area of Science:

  • Pediatric Cardiology
  • Developmental Pediatrics
  • Medical Genetics

Background:

  • Cardiac tumors are rare in infants.
  • Tuberous sclerosis is a genetic disorder with varied manifestations.
  • Early detection of tuberous sclerosis is crucial for management.

Observation:

  • Five infants presented with cardiac tumors detected via ultrasonography during fetal or early postnatal stages.
  • None of the infants exhibited hypomelanotic macules at birth.

Findings:

  • All five infants were subsequently diagnosed with tuberous sclerosis.
  • Tumor regression was observed in three infants.
  • Only one infant required surgical intervention for the cardiac tumor.
  • Hypomelanotic macules developed in all infants up to two years after birth.

Implications:

  • Ultrasonography detection of cardiac tumors in neonates warrants investigation for tuberous sclerosis.
  • The delayed appearance of hypomelanotic macules highlights the need for vigilant follow-up in diagnosing tuberous sclerosis.
  • Non-invasive monitoring and potential spontaneous regression of cardiac tumors in tuberous sclerosis should be considered in treatment planning.

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