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Resumen
Objetivo
Analizar la repercusión, evolución perinatal y asociación con esclerosis tuberosa de los tumores cardíacos
Sujetos y métodoEstudio retrospectivo de 18 casos diagnosticados prenatalmente (enero de 1991-diciembre de 2000) revisando características tumorales, repercusión y evolución posnatal (1-8 años)
ResultadosTodos los tumores se detectaron en exámenes rutinarios en gestantes de bajo riesgo (edad gestacional media, 32 semanas); en 17 (94%) eran aislados; en 10 (56%) existían varias masas, y en 8 (44%) sólo una. El tamaño osciló entre 1-46 mm, y la mayoría estaba en los ventrículos. En 16/18 fueron rabdomiomas (89%). La repercusión más frecuente fue derrame pericárdico (8, 44%). El manejo peri y posnatal fue conservador en la mayoría con reducción posnatal del tamaño en todos. La supervivencia ha sido del 67%. Hubo manifestaciones extracardíacas de esclerosis tuberosa en 5/16 rabdomiomas (31%). En todos había varias masas cardíacas
ConclusionesLos tumores cardíacos son raros y habitualmente múltiples. Por su localización y tamaño pueden provocar complicaciones graves, incluso la muerte, pero la mayoría cursa sin repercusiones significativas. Por ello, puede proponerse un tratamiento conservador, ya que pueden comportarse de manera benigna. En cuanto a la esclerosis tuberosa, el pronóstico es más incierto, principalmente cuando existen varias masas cardíacas
Palabras clave:
Tumores cardíacos
Diagnóstico prenatal
Esclerosis tuberosa
Summary
Objective
To analyze the effects and perinatal outcome of fetal cardiac tumors and their association with tuberous sclerosis
Subjects and methodsRetrospective analysis of 18 cases of prenatally diagnosed cardiac tumors (January 1991-December 2000). Tumoral characteristics, their effects, and postnatal outcome (1-8 years) were reviewed
ResultsAll cardiac tumors were detected in routine examinations in low-risk pregnant women (mean gestational age: 32 weeks). In 17 patients, the tumors were isolated findings (94%). In 10 patients (56%) there were several tumoral masses and in 8 (44%) only one. Size ranged from 1-46 mm. Most of the tumors were located in the ventricles. Sixteen out of 18 tumors were rhabdomyomas (89%). The most common consequence was pericardial effusion in 8 cases (44%). In most cases, peri- and postnatal management was conservative and all cases showed postnatal reduction in size. Overall survival was 67%. Extracardiac manifestations of tuberous sclerosis were found in 5/16 rhabdomyomas (31%). In all cases several cardiac masses were found
ConclusionsCardiac tumors are infrequent and are usually multiple. Because of their location and size, they can provoke serious complications, even death. In most cases, however, there are no significant disturbances. Therefore, a conservative approach is recommended as their behavior may be benign. The prognosis of tuberous sclerosis is less certain, especially when several cardiac masses are detected
Key words:
Cardiac tumors
Prenatal diagnosis
Tuberous sclerosis
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Bibliografía
[1.]
H.A. McAllister.
Primary tumors of the heart and pericardium.
Pathol Annu, 14 (1979), pp. 325-355
[2.]
A. Simcha, B.G. Wells, M.J. Tynan, D.J. Waterston.
Primary cardiac tumors in childhood.
Arch Dis Child, 46 (1971), pp. 508-514
[3.]
M.J. Perchinsky, S.V. Lichtenstein, G.F.O. Tyers.
Primary cardiac tumors. Forty years' experience with 71 patients.
Cancer, 79 (1997), pp. 1809-1815
[4.]
R.M. Lymburner.
Tumors of the heart: histopathological and clinical study.
Can Med Ass J, 30 (1934), pp. 368-375
[5.]
F.E. Fyke, J.B. Seward, W.D. Edwards, F.A. Miller, G.S. Reeder, T.T. Schattenberg, et al.
Primary cardiac tumors: experience with 30 consecutive patients since the introduction of twodimensional echocardiography.
J Am Coll Cardiol, 5 (1985), pp. 1465-1473
[6.]
M. Beghetti, R.M. Gow, I. Haney, J. Mawson, W.G. Williams, R.M. Freedom.
Pediatric primary benign cardiac tumors: a 15-year review.
Am Heart J, 134 (1997), pp. 1107-1114
[7.]
G.R. DeVore, S. Hakim, C.S. Kleinman, J.C. Hobbins.
The in utero diagnosis of an interventricular septal cardiac rhabdomyoma by means of real-time directed, M-mode echocardiography.
Am J Obstet Gynecol, 143 (1982), pp. 967-969
[8.]
K.H. Deeg, H.J. Voigt, M. Hofbeck, H. Singer, J. Kraus.
Prenatal ultrasound diagnosis of multiple cardiac rhabdomyomas.
Pediatr Radiol, 20 (1990), pp. 291-292
[9.]
J.F. Smythe, J.D. Dyck, J.F. Smallhorn, R.M. Freedom.
Natural history of cardiac rhabdomyoma in infancy and childhood.
Am J Cardiol, 66 (1990), pp. 1247-1249
[10.]
K.W. Green, R. Bors-Koefoed, P. Pollack, P.J. Weinbaum.
Antepartum diagnosis and management of multiple fetal cardiac tumors.
J Ultrasound Med, 10 (1991), pp. 697-699
[11.]
T. Geva, F. Santini, W. Pear, S.G. Driscoll, R. Van Praagh.
Cardiac rhabdomyoma. Rare cause of fetal death.
Chest, 99 (1991), pp. 139-143
[12.]
T. Watanabe, Y. Hojo, T. Kozaki, M. Nagashima, M. Ando.
Hypoplastic left heart syndrome with rhadbomyoma of the left ventricle.
Pediatr Cardiol, 12 (1991), pp. 121-122
[13.]
A.M. Groves, N.L. Fagg, A.C. Cook, L.D. Allan.
Cardiac tumours in intrauterine life.
Arch Dis Child, 67 (1992), pp. 1189-1192
[14.]
A.V. Mehta.
Rhabdomyoma and ventricular preexcitation syndrome. A report of two cases and review of the lieterature.
Ajdc, 147 (1993), pp. 669-671
[15.]
J. Hwa, C. Ward, G. Nunn, S. Cooper, K.C. Lau, G. Sholler.
Primary intraventricular cardiac tumors in children: contemporary diagnostic and management options.
Pediatr Cardiol, 15 (1994), pp. 233-237
[16.]
D.G. Holley, G.R. Martin, J.I. Brenner, D.A. Fyfe, J.C. Huhta, C.S. Kleinman, et al.
Diagnosis and management of fetal cardiac tumors: a multicenter experience and review of published reports.
J Am Coll Cardiol, 26 (1995), pp. 516-520
[17.]
C. Bordarier, A. Lellouch Tubiana, O. Robain.
Cardiac rhabdomyoma and tuberous sclerosis in three fetuses: a neuropathological study.
Brain Dev, 16 (1994), pp. 467-471
[18.]
M.L. Manco-Johnson, J.A. Drose.
Congenital cardiac tumors.
Fetal echocardiography, pp. 241-251
[19.]
C. Abad.
Tumores cardíacos (I). Generalidades.
Tumores primitivos benignos. Rev Esp Cardiol, 51 (1998), pp. 10-20
[20.]
C.O. Harding, R.A. Pagon.
Incidence of tuberous sclerosis in patients with cardiac rhabdomyoma.
Am J Med Genet, 37 (1990), pp. 443-446
[21.]
H. Werner, V. Mirlesse, F. Jacquemard, P. Sonigo, A.L. Delezoide, M. Gonzales, et al.
Prenatal diagnosis of tuberous sclerosis. Use of magnetic resonance imaging and its implications for prognosis.
Prenat Diagn, 14 (1994), pp. 1151-1154
[22.]
A. Nir, J. Tajik, W.K. Freeman, J.B. Seward, K.P. Offord, W.D. Edwards, et al.
Tuberous sclerosis and cardiac rhabdomyoma.
Am J Cardiol, 76 (1995), pp. 419-421
[23.]
P. Sonigo, A. Elmaleh, L. Fermont, A.L. Delezoide, V. Mirlesse, F. Brunelle.
Prenatal MRI diagnosis of fetal cerebral tuberous sclerosis.
Pediatr Radiol, 26 (1996), pp. 1-4
[24.]
R.H. Goh, R.E. Lappalainen, P.T. Mohide, C.C. Caco.
Multiple cardiac masses diagnosed with prenatal ultrasonography in the fetus of a woman with tuberous sclerosis.
Can Assoc Radiol J, 46 (1995), pp. 461-464
[25.]
F. Gutiérrez-Larraya, A. Galindo, J.I. Olaizola, M.T. Sotelo, G. Merino, P. De la Fuente.
Fetal cardiac tumors.
Rev Esp Cardiol, 50 (1997), pp. 187-191
[26.]
A. Geipel, M. Krapp, U. Germer, R. Becker, U. Gembruch.
Perinatal diagnosis of cardiac tumors.
Ultrasound Obstet Gynecol, 17 (2001), pp. 17-21
[27.]
A. Arciniegas, M. Hakimi, Z.Q. Farooki, N.J. Truccone, E. Green.
Primary cardiac tumors in children.
J Thoracic Cardiovasc Surg, 79 (1980), pp. 582-591
[28.]
L. Abushaban, B. Denham, D. Duff.
10 year review of cardiac tumors in childhood.
Br Heart J, 70 (1993), pp. 166-169
[29.]
A.P. Burke, M. Rosado de Christensen, P.A. Templeton, R. Virmani.
Cardiac fibroma: clinicopathological correlates and surgical treatment.
J Thoracic Cardiovasc Surg, 108 (1994), pp. 862-870
[30.]
J.L. Bass, G.N. Breningstall, K.F. Swaiman.
Echocardiographic incidence of cardiac rhabdomyoma in tuberous sclerosis.
Am J Cardiol, 55 (1985), pp. 1379-1382
[31.]
R. Rienmuller, J.L. Lloret, R. Tiling, J. Groh, W. Manert, K.D. Muller, et al.
MR imaging of pediatric cardiac tumors previously diagnosed by echocardiography.
J Comput Assist Tomogr, 13 (1989), pp. 621-626
[32.]
J.R. Seguin, P. Coulon, C. Huret, R. Grolleau-Roux, P.A. Chaptal.
Intrapericardial teratoma in infancy: a rare disease.
J Cardiovasc Surg, 27 (1986), pp. 509-511
[33.]
E.E. Salcedo, G.I. Cohen, R.D. White, M.B. Davison.
Cardiac tumors: diagnosis and management.
Curr Probl Cardiol, 17 (1992), pp. 73-137
[34.]
E.S. Roach, M. Smith, P. Huttenlocher, M. Bhat, D. Alcorn, L. Hawley.
Report of the diagnostic criteria committee of the national tuberous sclerosis association.
J Child Neurol, 7 (1992), pp. 221-224
[35.]
S. Yagel, A. Weissmann, Z. Rotstein, M. Manor, J. Hegesh, E. Anteby, et al.
Congenital heart defects: natural course and in utero development.
Circulation, 96 (1997), pp. 550-555
[36.]
M. Sgro, T. Barozzino, A. Toi, J. Johnson, M. Sermer, D. Chitayat.
Prenatal detection of cerebral lesions in a fetus with tuberous sclerosis.
Ultrasound Obstet Gynecol, 14 (1999), pp. 356-359
[37.]
M.A. Dennis, K. Appareti, M.L. Manco-Johnson.
The echocardiographic diagnosis of multiple fetal cardiac tumors.
J Ultrasound Med, 4 (1985), pp. 327-329
[38.]
S.E. Birnbaum, J.P. McGahan, G.G. Hanos.
Fetal tachycardia and intramyocardial tumors.
J Am Coll Cardiol, 6 (1985), pp. 1358-1361
[39.]
C.D. Gresser, J. Shime, H. Rakowski.
Fetal cardiac tumor: a prenatal echocardiographic marker for tuberous sclerosis.
Am J Obstet Gynecol, 156 (1987), pp. 689-690
[40.]
J.M. Brand, D.Z. Friederg.
Spontaneous regression of a primary cardiac tumor presenting as fetal tachyarrythmias.
J Perinatol, 12 (1992), pp. 48-50
[41.]
O. Uzun, G. McGawley.
Wharton GA. Multiple cardiac rhabdomyomas: tuberous sclerosis or not?.
Heart, 77 (1997), pp. 388
[42.]
D. Paladini, S. Palmieri, M.G. Russo, G. Pacileo.
Cardiac multiple rhabdomyomatosis: prenatal diagnosis and natural hystory.
Ultrasound Obstet Gynecol, 7 (1996), pp. 84-85
[43.]
B.J. Gushiken, P.W. Callen, N.H. Silverman.
Prenatal diagnosis of tuberous sclerosis in monozygotic twins with cardiac masses.
J Ultrasound Med, 18 (1999), pp. 165-168
[44.]
E.G. Muhler, V. Turniski-Harder, W. Engelhardt, G. Von Bernuth.
Cardiac involvement in tuberous sclerosis.
Br Heart J, 72 (1994), pp. 584-590
[45.]
K.J. Brackley, P.A. Farndon, J.B. Weaver, D.J. Dow, S. Chapman, M.D. Kilby.
Prenatal diagnosis of tuberous sclerosis with intracerebral signs at 14 weeks' gestation.
Prenat Diagn, 19 (1999), pp. 575-579
[46.]
G.P. Giacoia.
Fetal rhabdomyoma: a prenatal echocardiographic marker of tuberous sclerosis.
Am J Perinatol, 9 (1992), pp. 111-114
[47.]
G.A. Russell, J.P. Dhasmana, P.J. Berry.
Coexistent cardiac tumors and malformations of the heart.
Int J Cardiol, 22 (1989), pp. 89-98
[48.]
M. Krapp, A.A. Baschat, U. Gembruch, K. Gloeckner, E. Schwinger, E. Reusche.
Tuberous sclerosis with intracardiac rhabdomyoma in a fetus with trisomy 21: case report and review of literature.
Prenat Diagn, 19 (1999), pp. 610-613
[49.]
L.G. Van der Hauwert.
Cardiac tumors in infancy and childhood.
Br Heart J, 33 (1971), pp. 125-132
[50.]
A. Alkalay, D. Ferry, B. Lin, B. Fink, J. Pomerance.
Spontaneous regression of cardiac rhabdomyoma in tuberous sclerosis.
Clin Ped, 26 (1987), pp. 532-535
[51.]
N. Fujita, G.R. Caputo, C.B. Higgins.
Diagnosis and characterisation of intracardiac masses by magnetic resonance imaging.
Am J Card Imag, 8 (1994), pp. 69-80
[52.]
T.L. Coates, J.P. McGahan.
Fetal cardiac rhabdomyomas presenting as diffuse myocardial thickening.
J Ultrasound Med, 13 (1994), pp. 813-816
[53.]
J. Fenoglio, H. McAllister, V. Ferrans.
Cardiac rhabdomyoma: a clinicopathologic and electron microscopic study.
Am J Cardiol, 38 (1976), pp. 241-251
[54.]
R. Bini, S. Westaby, L. Bargeron, A. Pacifico, J. Kirklin.
Investigation and management of primary cardiac tumors in infants and children.
J Am Coll Cardiol, 2 (1983), pp. 351-357
[55.]
S. Cassidy.
Tuberous sclerosis in children. Diagnosis and course.
Comprehens Ther, 10 (1984), pp. 43-49
[56.]
R.D. Ross, S.E. Paridon, P.A. Humes, P.P. Karpawich, K. Pinsky.
Spontaneous regression of cardiac rhabdomyoma.
Am J Cardiol, 64 (1989), pp. 416-419
[57.]
Z.Q. Farooki, R.D. Ross, S.M. Paridon.
Spontaneous regression of cardiac rhabdomyoma.
Am J Cardiol, 67 (1991), pp. 897-899
[58.]
G. Distefano, P. Sciacca, C. Mattia, G. Tornambene.
Cardiac involvement in tuberous sclerosis in the first month of life: physiopathologic and clinical aspects of cardiac rhabdomyoma.
Pediatr Med Chir, 20 (1998), pp. 29-32
[59.]
D. Satge, B. De Geeter.
Rhabdomyomes cardiaques et apoptose: les regressions sont-elles controlees par l'organisme?.
Arch Mal Coeur Vaiss, 85 (1992), pp. 603-608
[60.]
J. Ortiz, H. Pereira Maghalaes, A. Malta de Souza, C.E.S. Silva.
Spontaneous regression of cardiac tumors.
Echocardiography, 9 (1992), pp. 253-256
[61.]
C.A. Dietl, A.R. Torres, R.G. Favaloro.
Ventricular tumors: surgical options.
Cardiovasc Surg, 1 (1993), pp. 632-637
[62.]
T. Todros, P. Gaglioti, P. Presbitero.
Management of a fetus with intrapericardial teratoma diagnosed in utero.
J Ultrasound Med, 10 (1991), pp. 287-290
[63.]
S.L. Rasmussen, W.S. Hwang, J. Harder, S. Nicholson, D. Davies, C.A. Nimrod.
Intrapericardial teratoma ultrasonic and pathological features.
J Ultrasound Med, 6 (1987), pp. 159-162
[64.]
H.S. Weber, C.S. Kleinman, W.E. Hellebrand, G.S. Kopf, J. Copel.
Development of a benign intrapericardial tumor between 20 and 40 weeks of gestation.
Pediatr Cardiol, 9 (1988), pp. 153-156
[65.]
D.R. Cyr, Guntheroth, D.A. Nyberg, J.R. Smith, S.R. Mudelman, M. Ek.
Prenatal diagnosis of an intrapericardial teratoma.
J Ultrasound Med, 7 (1988), pp. 87-90
[66.]
M. Alegre, M. Torrents, E. Carreras, C. Mortera, V. Cusi, J.M. Carrera.
Prenatal diagnosis of intrapericardial teratoma.
Pediatr Diagn, 10 (1990), pp. 199-202
[67.]
K.S. Rheuban, N.L. McDaniel, P.S. Feldman, D.C. Mayes, B.M. Rodgers.
Intrapericardial teratoma causing non-immune hydrops fetalis and pericardial tamponade: a case report.
Pediatr Cardiol, 12 (1991), pp. 54-56
[68.]
A. Pérez-Aytes, N. Sanchis, A. Barbal, M.J. Artes, J. Domene, M. Chirivella, et al.
Non-immunological hydrops fetalis and intrapericardial teratoma: case report and review, 15 (1995), pp. 859-863
[69.]
S. Riskin-Mashiah, K.J. Moise, I. Wilkins, N.A. Ayres, C.D. Fraser.
In utero diagnosis of intrapericardial teratoma: a case for in utero open fetal surgery.
Prenat Diagn, 18 (1998), pp. 1328-1330
[70.]
S.W. Bruch, N.S. Adzick, R. Reiss, M.R. Harrison.
Prenatal therapy for pericardial teratomas.
J Pediatr Surg, 32 (1997), pp. 1113-1115
[71.]
M. Sklansky, M. Greenberg, V. Lucas, A. Gruslin-Giroux.
Intrapericardial teratoma in a twin fetus: diagnosis and management.
Obstet Gynecol, 89 (1997), pp. 807-809
[72.]
A. Benatar, J. Vaughan, U. Nicolini, S. Trotter, B. Corrin, C. Lincoln.
Prenatal pericardiocentesis: its role in the management of intrapericardial teratoma.
Obstet Gynecol, 79 (1992), pp. 856-859
[73.]
I.W. Brown, J.P. McGoldrick, A. Robles.
Left ventricular fibroma: echocardiographic diagnosis and successful surgical excision in three cases.
J Cardiovasc Surg, 31 (1990), pp. 536-540
[74.]
M. Filiatrault, M.J. Beland, K.A. Neilson.
Cardiac fibroma presenting with clinically significant arrhythmias in infancy.
Pediatr Cardiol, 12 (1991), pp. 118-120
[75.]
H. Muñoz, D.M. Sherer, R. Romero, J. Sánchez, I. Hernández, C. Díaz.
Prenatal sonographic findings of a large fetal cardiac fibroma.
J Ultrasound Med, 14 (1995), pp. 479-481
[76.]
K. Numata, H. Tomita.
Cardiac fibroma in an infant: comparison of echocardiographic findings with rhabdomyoma.
J Cardiol, 24 (1994), pp. 71-76
[77.]
G.M. García-Rostan, C. De Miguel, A. Puras, M. Ezcurdia, J. Yanguas.
Hydrops fetalis severo y placenta hidrópica asociados a fibroma cardíaco. Descripción de un caso y revisión de la literatura.
Prog Obstet Ginecol, 39 (1996), pp. 763-770
[78.]
R.E. Leithiser, D. Fyfe, I.I.I. Weatherby E, R. Sade, A.J. Garvin.
Prenatal sonographic diagnosis of atrial hemangioma.
Am J Roentgenol, 147 (1986), pp. 1207-1208
[79.]
J.J. Tseng, M.M. Chou, Y.H. Lee, E.S.C. Ho.
In utero diagnosis of cardiac hemangioma.
Ultrasound Obstet Gynecol, 13 (1999), pp. 363-365
[80.]
D.I. Bulas, D. Johnson, J.F. Allen, S. Kapur.
Fetal hemangioma. Sonographic and color flow doppler findings.
J Ultrasound Med, 11 (1992), pp. 499-501
[81.]
A.M. Cartagena, T.L. Levin, H. Issenberg, H.S. Goldman.
Pericardial effusion and cardiac hemangioma in the neonate.
Pediatr Radiol, 23 (1993), pp. 384-385
[82.]
R. Galli, S. Albanese, D. Pilato, M. Longo, R. Fattori, M. Ferlito, et al.
The surgical treatment of a rare primary cardiac tumor: hemangioma. A report of 2 cases.
Cardiologia, 42 (1997), pp. 89-93
[83.]
T.E. Palmer, D.D. Tresch, L.I. Bonchek.
Spontaneous resolution of a large, cavernous hemangioma of the heart.
Am J Cardiol, 58 (1986), pp. 184
[84.]
C.L. Case, P.C. Gillette, F.A. Crawford.
Cardiac rhabdomyomas causing supraventricular and lethal ventricular arrhythmias in an infant.
Am Heart J, 122 (1991), pp. 1484-1486
[85.]
W.C. Roberts.
Primary and secondary neoplasms of the heart.
Am J Cardiol, 80 (1997), pp. 671-682
[86.]
V. Tsakraklides, B. Burke, A. Mastri, W. Runge, E. Roe, R. Anderson.
Rhabdomyomas of the heart.
Am J Dis Child, 128 (1974), pp. 639-646
[87.]
P.B. Jakayar, R.S. Stanwick, S.S. Seshia.
Tuberous sclerosis and Wolff-parkinson-White syndrome.
J Pediatr, 108 (1986), pp. 259-260
[88.]
S. Milner, J.A. Abramowitz, S. Levin.
Rhabdomyoma of the heart in a newborn infant: diagnosis by echocardiography.
Br Heart J, 46 (1980), pp. 224-227
[89.]
M.H. Soltan, C. Keohane.
Hydrops fetalis due to congenital cardiac rhabdomyoma.
Br J Obstet Gynaecol, 88 (1981), pp. 771-773
[90.]
S.D. Hoadley, R.L. Wallace, J.F. Miller, J.P. Murgo.
Prenatal diagnosis of multiple cardiac tumors presenting as an arrhythmia.
J Clin Ultrasound, 14 (1986), pp. 639-643
[91.]
H. Yamashita, H. Nagaoka, R. Matsushia.
Cardiac rhabdomyoma associated with tuberous sclerosis: an autopsy case of newborn infant died of cardiac failure.
Acta Pathol Jpn, 37 (1987), pp. 645-653
[92.]
C. San Román, A. Lazcoz, E. Pastor, J.M. Galdeano, A. Cabrera.
Rabdomioma biventricular o un caso de regresión espontánea. Estudio con ecocardiografía bidimensional.
Rev Esp Cardiol, 46 (1993), pp. 198-200
[93.]
J.R. Sampson, S.J. Scahill, J.B.P. Stephenson, L. Mann, J.M. Connor.
Genetic aspects of tuberous sclerosis in the west of Scotland.
J Med Genet, 26 (1989), pp. 28-31
[94.]
R.L. Beauchamp, A. Banwell, P. McNamara, M. Jacobson, E. Higgins, H. Northrup, et al.
Exon scanning of the entire TSC2 gene for germline mutations in 40 unrelated patients with tuberous sclerosis.
Hum Mutat, 12 (1998), pp. 408-416
[95.]
M.L. Buyse.
Tuberous sclerosis.
Birth defects encyclopedia, pp. 1712-1713
[96.]
S. Jozwiak, W. Kawalec, J. Dluzewska, J. Daszkowska, M. Mirkowicz- Malek, R. Michalowicz.
Cardiac tumors in tuberous sclerosis: their incidence and course.
Eur J Pediatr, 153 (1994), pp. 155-1557
[97.]
J.Y. Choi, E.J. Bae, C.I. Noh, Y.S. Yoon, Y.S. Hwang.
Cardiac rhabdomyoma in childhood tuberous sclerosis.
Cardiol Young, 5 (1995), pp. 166-171
[98.]
D.C. Crawford, C. Garett, M.J. Tynan.
Cardiac rhabdomyomas as a marker fot the antenatal detection of tuberous sclerosis.
J Med Genet, 20 (1983), pp. 303-307
[99.]
C.D. Gresser, J. Shime, H. Rakowski, J.F. Smallhorn, A. Hui, J.J. Berg.
Fetal cardiac tumor: a prenatal echocardiographic marker for tuberous sclerosis.
Am J Obstet Gynecol, 156 (1987), pp. 689-690
[100.]
H.C. Smith, G.H. Watson, R.G. Patel, M. Super.
Cardiac rhabdomyomata in tuberous sclerosis: their course and diagnostic value.
Arch Dis Child, 64 (1989), pp. 196-200
[101.]
G. Wallace, H.C. Smith, G.H. Watson, S. Rimmer, S.W. D'Souza.
Tuberous sclerosis presenting with fetal and neonatal cardiac tumours.
Arch Dis Child, 65 (1990), pp. 377-379
[102.]
H. Journel, M. Roussey, M.H. Plais, J. Millon, C. Almange, B. Le Marec.
Prenatal diagnosis of familial tuberous sclerosis following detection of cardiac rhabdomyoma by ultrasound.
Prenatal Diagn, 6 (1986), pp. 283-289
[103.]
A.E. Fryer, A. Chalmers, J.M. Connor, I. Fraser, S. Povey, A.D. Yates, et al.
Evidence that the gene for tuberous sclerosis is on chromosome 9.
Lancet, 1 (1987), pp. 659-661
[104.]
R.S. Kandt, J.L. Haines, M. Smith, H. Northrup, R.J.M. Gardner, M.P. Short, et al.
Linkage of an important gene locus for tuberous sclerosis to a chromosome 16 marker for polycystic hidney disease.
Nat Genet, 2 (1992), pp. 37-41
[105.]
D.J. Kwiatkowski, D. Colette, S.A. Slaugenhaupt, S. Povey, J.F. Gusella, J.L. Haines.
An index marker map of chromosome 9 provides strong evidence for positive interference.
Am J Hum Genet, 53 (1993), pp. 1279-1288
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