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[The complete regression of multiple cardiac rhabdomyomas in childhood]
F De Conti1, P Piovesana, P Viena
1Servizio di Cardiologia, Ospedale P. Cosma, Camposampiero, PD.
Insights
This case study highlights a rare cardiac rhabdomyoma in a newborn that spontaneously regressed. Echocardiography confirmed the complete resolution of tumors, demonstrating a favorable outcome for infantile cardiac rhabdomyoma.
Area of Science:
- Pediatric Cardiology
- Oncology
- Medical Imaging
Background:
- Rhabdomyoma is the most common primary cardiac tumor in infants and children, though rare overall.
- Cardiac rhabdomyomas can present with various clinical manifestations, including arrhythmias and outflow tract obstruction.
- Tuberous Sclerosis is a genetic disorder often associated with cardiac rhabdomyomas.
Observation:
- A newborn presented with multiple intramural and intracavitary cardiac masses detected via two-dimensional echocardiography.
- The infant exhibited supraventricular arrhythmias but was otherwise asymptomatic, with no signs of distress, murmur, or cardiomegaly on chest roentgenogram.
- Association with Tuberous Sclerosis was ruled out, and Doppler studies indicated no significant inflow or outflow tract obstruction.
Findings:
- Serial echocardiography demonstrated complete regression of the cardiac rhabdomyomas by the two-year follow-up.
- The patient remained asymptomatic throughout the follow-up period.
- A noninterventional approach was successfully employed due to the absence of hemodynamic compromise.
Implications:
- This case underscores the potential for spontaneous regression of infantile cardiac rhabdomyomas.
- Echocardiography is a crucial tool for diagnosing, monitoring, and assessing the prognosis of cardiac rhabdomyomas.
- A conservative management strategy can be effective in select cases of neonatal cardiac rhabdomyoma without significant obstruction.
Abstract:
Rhabdomyoma, even if rare, is the most common primary cardiac tumor in infancy and childhood. We present the case of a newborn in whom several intramural and intracavitary cardiac masses were found at birth by two-dimensional echocardiography, and showed complete regression at the follow-up examinations. Except for supraventricular arrhythmias, there were no symptoms or signs of cardiac involvement at birth: the baby was acyanotic and is no apparent distress; no murmur was detected and chest roentgenogram revealed normal heart size; association with Tuberous Sclerosis was excluded. Despite major anatomical cardiac anomaly, neither in-flow nor out-flow tract obstruction was found by Doppler investigation and therefore a noninterventional approach was preferred. At the two-year follow-up control the baby was asymptomatic and the echocardiogram revealed complete regression of cardiac tumors. Our report confirms the possible favourable outcome of Rhabdomyoma and the utility of echocardiography in these patients' follow-up.