title: Diagnosis and management of fetal cardiac tumors: a multicenter experience and review of published reports.
abstract: OBJECTIVE
  We sought to determine the prevalence and natural history of cardiac tumors in patients referred for fetal echocardiography.
  
  
  BACKGROUND
  Cardiac tumors are rare; the prevalence, reported from autopsy studies of patients of all ages, varies from 0.0017% to 0.28%. Despite many case reports, the prevalence and natural history of fetal cardiac tumors are unclear.
  
  
  METHODS
  Fourteen thousand fetal echocardiograms recorded over an 8-year period in seven centers were available for retrospective review. Medical records and echocardiograms were studied to determine the reason for referral, family history of tuberous sclerosis, prenatal and postnatal course and tumor description and type.
  
  
  RESULTS
  Cardiac tumors were present in 19 pregnancies (0.14%). Gestational age at diagnosis ranged from 21 to 38 weeks. The most common indication for referral was a mass on an obstetric ultrasound study. The tumors were singular in 10 patients and multiple in 9. Tumor size ranged from 0.4 x 0.4 to 3.5 x 4 cm, and the majority of tumors were not hemodynamically significant. There were 17 patients with rhabdomyomas, 1 with a fibroma and 1 with an atrial hemangioma. Tuberous sclerosis complex was diagnosed in 10 patients. Partial or complete tumor regression was seen in eight patients; tumors were unchanged in five; and three required operation.
  
  
  CONCLUSIONS
  Fetal cardiac tumors, a rare condition, are often benign. The majority of tumors are rhabdomyomas, but not all fetuses with rhabdomyoma have tuberous sclerosis.
authors.affiliation: Children's National Medical Center, Washington, D.C., USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Holley
authors.forename: G R
authors.initials: GR
authors.lastname: Martin
authors.forename: J I
authors.initials: JI
authors.lastname: Brenner
authors.forename: D A
authors.initials: DA
authors.lastname: Fyfe
authors.forename: J C
authors.initials: JC
authors.lastname: Huhta
authors.forename: C S
authors.initials: CS
authors.lastname: Kleinman
authors.forename: S B
authors.initials: SB
authors.lastname: Ritter
authors.forename: N H
authors.initials: NH
authors.lastname: Silverman
mesh_terms: D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D005865:Gestational Age; D006338:Heart Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D009365:Neoplasm Regression, Spontaneous; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D015995:Prevalence; D012189:Retrospective Studies; D012207:Rhabdomyoma / Q000000981:diagnostic imaging / Q000628:therapy; D016216:Ultrasonography, Prenatal