Evaluating the risk of tuberous sclerosis in cases with prenatal diagnosis of cardiac rhabdomyoma.
OBJECTIVE
To evaluate the prenatal parameters that increase the risk of tuberous sclerosis in prenatal management of fetal cardiac tumors suspected as rhabdomyoma.


METHODS
The study was a retrospective survey of 18 documented cases in which cardiac rhabdomyoma was suspected during pregnancy. The following parameters were evaluated as possible risk factors associated with tuberous sclerosis: tumor size, isolated or multiple, and family history of tuberous sclerosis.


RESULTS
Eighteen documented cases in which cardiac rhabdomyoma was found during pregnancy were evaluated. Of these cases, seven (39%) had proven tuberous sclerosis and 11 were found to be non-associated tuberous sclerosis tumors. When combining the present data with previous series, cases with diagnosis of tuberous sclerosis had equal mean tumor size to those with normal outcome. Family history of tuberous sclerosis in the presence of cardiac rhabdomyoma almost invariably ended with tuberous sclerosis (86%). All other cases with diagnosis of tuberous sclerosis and no family history had all multiple cardiac tumors.


CONCLUSIONS
The present data suggest that 39% of in utero suspected cardiac rhabdomyoma would have tuberous sclerosis. Family history and multifocality remain the strongest predictors of tuberous sclerosis, whereas size of the cardiac tumor can not reliably be used to predict tuberous sclerosis in prenatal counseling.
Gamzu
Ronni
R
Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Hashomer, Israel.
Achiron
Reuven
R
Hegesh
Julius
J
Weiner
Ehud
E
Tepper
Ron
R
Nir
Amiram
A
Rabinowitz
Ron
R
Auslander
Ron
R
Yagel
Simcha
S
Zalel
Yaron
Y
Zimmer
Etan
E
D000328:Adult; D001921:Brain / Q000002:abnormalities; D005260:Female; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D014402:Tuberous Sclerosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D014463:Ultrasonography