Fetal Demise Secondary to Massive Rhabdomyoma in the Early Second Trimester of Pregnancy
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Rhabdomyoma is the most common cardiac tumor in fetuses, often associated with tuberous sclerosis complex and usually diagnosed in the third trimester of pregnancy, with a benign course in the majority of cases. The hemodynamic impact of cardiac tumor depends on the location and size of the mass and the presence of dysrhythmia (4). Fetal cardiac rhabdomyoma accounts for less than 10% of fetal demise cases (1). This report presents a case of massive cardiac rhabdomyoma filling the entire right heart with pericardial extension, leading to hydrops and subsequent fetal death in the early second trimester of pregnancy.
KeywordsCardiac tumor Fetal demise Hydrops Pericardial extension Rhabdomyoma Tuberous sclerosis complex
Video clip 1 Four-chamber view showing multiple rhabdomyomas engulfing the majority of the right atrium and ventricle cavities, with moderate pericardial effusion. (AVI 36004 kb)
Video clip 2 Right ventricular outflow Doppler showing nonpulsatile to-and-fro flow and severe mitral regurgitation. (AVI 29254 kb)
Video clip 3 Short-axis view showing a massive tumor obliterating the right heart and severe mitral regurgitation. (AVI 22953 kb)