Yuan Shi-Min
Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian 351100, Fujian Province, China.
Pediatr Neonatol. 2017 Jun;58(3):205-210. doi: 10.1016/j.pedneo.2016.07.004. Epub 2016 Oct 28.
Fetal primary cardiac tumors are rare, but they may cause complications, which are sometimes life threatening, including arrhythmias, hydrops fetalis, ventricular outflow/inflow obstruction, cardiac failure, and even sudden death. Among fetal primary cardiac tumors, rhabdomyomas are most common, followed by teratomas, fibromas, hemangiomas, and myxomas. Everolimus, a mammalian target of rapamycin inhibitor, has been reported to be an effective drug to cause tumor remission in three neonates with multiple cardiac rhabdomyomas. Neonatal cardiac surgery for the resection of primary cardiac tumors found by fetal echocardiography has been reported sporadically. However, open fetal surgery for pericardial teratoma resection, which was performed successfully via a fetal median sternotomy in one case report, could be a promising intervention to rescue these patients with large pericardial effusions. These recent achievements undoubtedly encourage further development in early management of fetal cardiac tumors. Owing to the rarity of fetal primary cardiac tumors, relevant information in terms of prenatal diagnosis, treatment, and prognosis remains to be clarified.
胎儿原发性心脏肿瘤很少见，但可能引起并发症，有时甚至危及生命，包括心律失常、胎儿水肿、心室流出道/流入道梗阻、心力衰竭，甚至猝死。在胎儿原发性心脏肿瘤中，横纹肌瘤最为常见，其次是畸胎瘤、纤维瘤、血管瘤和黏液瘤。依维莫司是一种雷帕霉素哺乳动物靶点抑制剂，据报道，它是一种有效的药物，可使3例患有多发性心脏横纹肌瘤的新生儿肿瘤缓解。胎儿超声心动图发现原发性心脏肿瘤后，新生儿心脏手术切除肿瘤的报道较为零散。然而，在一份病例报告中，通过胎儿正中胸骨切开术成功进行的开放性胎儿心包畸胎瘤切除术，可能是一种有前景的干预措施，可挽救这些伴有大量心包积液的患者。这些最新成果无疑鼓励了胎儿心脏肿瘤早期管理的进一步发展。由于胎儿原发性心脏肿瘤罕见，产前诊断、治疗和预后方面的相关信息仍有待明确。
