Información del artículo
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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