Gutiérrez-Larraya Aguado F, Galindo Izquierdo A, Olaizola Llodio J I, Sotelo Rodríguez M T, Merino Batres G, Velasco Bayón J M, Pérez Martínez A, de Castro Fernández J, Ordóñez Pérez D, de la Fuente Pérez P
Sección de Cardiología Pediátrica, Hospital Materno-Infantil 12 de Octubre, Madrid.
Rev Esp Cardiol. 1997 Mar;50(3):187-91. doi: 10.1016/s0300-8932(97)73202-0.
Fetal cardiac tumors are rare and have a different histology than in adults: in the fetus, rhabdomyoma is more prevalent, but myxoma has not been described. We report our experience with nine fetuses with prenatally diagnosed primary cardiac tumours.
This is an observational and descriptive study of fetuses investigated because of the prenatal and echographic diagnosis of heart tumors.
There were nine fetuses with thirteen cardiac masses among more than 700 fetal echocardiographic studies performed by pediatric cardiologists. Histology was available in four of them; three rhabdomyomas and once cavernous hemangioma. In one of the cases, the parents elected to interrupt the pregnancy; three patients died in the neonatal period (two as a direct consequence of the tumors and one due to sepsis) and we have no histological information regarding any of the other five fetuses. The subjects who survived beyond the neonatal period are mostly doing well. However, one developed tuberous sclerosis and another developed a hypoplastic left heart syndrome, perhaps due to the massive restriction of flow across the foramen ovale. The tumors in the other cases were well tolerated and hemodynamic or arrhythmic consequences were minimal of absent. No women with risk factors such as tuberous sclerosis were included in our study.
Fetal cardiac tumors are rare and display a different histology. We recommend a conservative approach to treatment.
胎儿心脏肿瘤较为罕见,其组织学与成人不同:在胎儿中,横纹肌瘤更为常见,但黏液瘤尚未见报道。我们报告了9例产前诊断为原发性心脏肿瘤的胎儿的相关经验。
这是一项对因产前超声心动图诊断为心脏肿瘤而接受检查的胎儿进行的观察性描述性研究。
在儿科心脏病专家进行的700多次胎儿超声心动图检查中,有9例胎儿发现了13个心脏肿物。其中4例有组织学诊断结果;3例为横纹肌瘤,1例为海绵状血管瘤。其中1例,父母选择终止妊娠;3例新生儿期死亡(2例直接死于肿瘤,1例死于败血症),另外5例胎儿我们没有组织学信息。存活至新生儿期后的患儿大多情况良好。然而,1例发展为结节性硬化症,另1例发展为左心发育不全综合征,可能是由于卵圆孔处血流严重受限所致。其他病例中的肿瘤耐受性良好,血流动力学或心律失常后果轻微或无。我们的研究未纳入有结节性硬化症等危险因素的女性。
胎儿心脏肿瘤罕见,且组织学不同。我们建议采取保守治疗方法。