Can a fetus with rhabdomyomas give birth?

Generally speaking, most fetal rhabdomyomas are benign tumors, and they will shrink with the increase of gestational weeks, and there is a certain degree of self-healing ability. However, for children who cannot heal on their own, surgery is usually required after birth, and chemotherapy is not required in this case. Generally, do not throw away the child with fetal rhabdomyomas. Do prenatal examinations regularly, and once the child is born, the treatment must be based on the situation.

Cardiac rhabdomyoma is a rare primary cardiac tumor with skeletal muscle differentiation. It is the second most common benign cardiac tumor after cardiac myxoma and the most common primary cardiac tumor in children, especially in newborns and infants. Literature reports that its prenatal detection rate is approximately 0.06%, with no significant gender difference.

Cardiac rhabdomyomas are considered to be myocardial hamartomas rather than true tumors. They may be derived from fetal cardiac myoblasts. Because many cases also have lesions such as tuberous sclerosis of the brain, they are considered to be tumor-like hyperplasia of the myocardium. One-third to one-half of primary cardiac rhabdomyomas in children are related to tuberous sclerosis, which is a chromosomal dominant inheritance and may be complicated by brain hamartomas, facial sebaceous adenomas, and renal angiomyolipomas. Recently, some scholars believe that cardiac rhabdomyomas may be caused by delayed or failed apoptosis in part of the normal replication process of the heart.

Clinical manifestations

Cardiac rhabdomyomas have a variety of clinical manifestations, including heart murmurs, arrhythmias, heart failure, and other associated symptoms. These differences may vary depending on the degree of hemodynamic changes such as left or right heart blood flow obstruction, myocardial involvement, and rhythm disturbances.

The clinical presentation of patients with cardiac rhabdomyomas depends on the size, number, and location of the tumors. Small tumors are generally asymptomatic, but larger tumors may block cardiac chambers or valves, causing significant hemodynamic compromise. Tricuspid valve obstruction may produce right-to-left shunt through the foramen ovale, resulting in cyanosis. Involvement of the conduction system may produce serious arrhythmias, including complete atrioventricular block and ventricular tachycardia that is difficult to control with drugs. Fetal rhabdomyomas

1. Cardiac echocardiography

It is non-invasive, easy and inexpensive, and is the first-line diagnostic method for cardiac tumors. Rhabdomyomas are essentially solid tumors within the myocardium that invade many areas of the myocardium, ranging in diameter from a few millimeters to several centimeters. Although they vary in size, they show the same echogenic mass. Large rhabdomyomas may cause obstruction of the inflow or outflow tract of the left or right cardiac chambers, but no pericardial effusion has been reported.

2. Cardiovascular angiography

It can show rhabdomyomas as multiple filling defects in the cardiac cavity, but the examination is expensive and requires multiple injections of contrast agents and catheter trauma, which are its main shortcomings, so it is rarely used.

3. MRI (magnetic resonance imaging)

It is non-invasive and can image in any cross section at multiple angles. It can accurately locate, quantify and even characterize tumors, and has unique advantages.

4. CT scan