P32.07: Fetal cardiac rhabdomyoma diagnosed at twenty weeks of gestation: a case report

Abstract

Primary cardiac tumors are rare, with an estimated incidence of 0.27% among pediatric autopsies. The most common cardiac tumor in fetus and infancy is rhabdomyoma, which tends to occur at a frequency of 0.08% among live-born infants. Rhabdomyomas are associated with tuberous sclerosis complex (TSC) in 50–86% of cases, manifested by seizures, learning/behavorial dificulties, skin lesions and renal abnormalities. The tumor tends to appear between 20 and 30 weeks' gestation as a well-circumscribed hyperechoic and homogeneous masses of variable size and usually at multiple loci. Fetal cerebral MRI is a sensitive imaging tool for evaluation of the fetal brain. Cardiac rhabdomyomas and subependymal nodules demonstrated by MRI, are the two major criteria for the diagnosis of TSC. We report the case of a 38-year-old gravida 2 para 1 aborta 1, who came for a sonographic examination at 21 weeks. The sonographic examination revealed an isolated hyperechoic mass of 6.5 mm located at (anillo de inserción de la válvula tricúspide). The size of the cardiac mass have remain unchanged until 37 weeks (the patient is still pregnant). A MRI examination was performed at 27 and 35 weeks, with no evidence of fetal brain lesions. There is no familiar history of TSC. However, normal findings on prenatal MRI of the fetal brain do not completely exclude postnatal tuberous sclerosis.