Fetal Cardiac Myxomas

Abstract

Fetal cardiac myxomas are very rare. To date there has been no representative description of fetal cardiac myxomas. The aim of this study is to highlight the clinical features, possible outcomes and the disparities from the adult cardiac myxomas and other fetal cardiac tumors.

A comprehensive literature review yielded 27 reports including 32 cases of fetal cardiac myxomas.

Apart from the same pedunculated and solitary nature and echogenic appearance, fetal cardiac myxomas differ from those in adults in many aspects, including tumor location, clinical manifestation and malignant potential. Fetal cardiac myxomas are the most common in the left ventricle and the least common in the left atrium. Tumor size and tumor site could be predictive risk factors of adverse cardiac events of fetuses.

Their clinical courses are often benign with fewer cases of adverse cardiac events. Prenatal echocardiography is a reliable diagnostic technique, which can detect cardiac myxomas at as early as 18 weeks gestation. Differential diagnosis should be made from other types of fetal cardiac tumors. Postnatal cardiac myxoma resection may provide a good prognosis.

Key words

heart neoplasms - myxoma - prenatal diagnosis

• References

• 1 Groves AM, Fagg NL, Cook AC. et al. Cardiac tumours in intrauterine life. Arch Dis Child 1992; 67 10 Spec No 1189-1192
• 2 Holley DG, Martin GR, Brenner JI. et al. Diagnosis and management of fetal cardiac tumors: a multicenter experience and review of published reports. J Am Coll Cardiol 1995; 26: 516-520
• 3 Gutiérrez-Larraya Aguado F, Galindo Izquierdo A, Olaizola Llodio JI. et al. Tumores cardíacos fetales. Rev Esp Cardiol 1997; 50: 187-191 [Article in Spanish]
• 4 Savío Benavides A, Oliva Rodríguez J, García Morejón C. et al. Diagnóstico ecocardiográfico de los tumores primarios del corazón en el feto. Rev Cubana Pediatr 2009; 81: 1-9 [Article in Spanish]
• 5 Isaacs Jr. H. Fetal and neonatal cardiac tumors. Pediatr Cardiol 2004; 25: 252-273
• 6 Amelia A, Nizam M. Perinatal management of cardiac tumors: a case series. Med J Malaysia 2013; 68: 374-375
• 7 Paladini D, Tartaglione A, Vassallo M. et al. Prenatal ultrasonographic findings of a cardiac myxoma. Obstet Gynecol 2003; 102 5 Pt 2 1174-1176
• 8 Ríos JC, Chávarri F, Morales G. et al. Cardiac myxoma with prenatal diagnosis. World J Pediatr Congenit Heart Surg 2013; 4: 210-212
• 9 Chen YX. Ultrasound diagnosis of fetal left ventricular myxoma: a case report. Chin J Ultrasound Diagn 2003; 4: 660 [Article in Chinese]
• 10 Dong ZL, Wu L, Li Y. et al. Fetal left ventricular myxoma diagnosed by color Doppler ultrasound: a case report. Inner Mongolia Med J 2005; 37: 700 [Article in Chinese]
• 11 Duo SL. Ultrasound diagnosis of fetal right atrial myxoma: a case report. J Ultras Clin Med 2014; 16: 854 [Article in Chinese]
• 12 Dou FT, Lu LP, Wang CX. et al. Application of color Doppler ultrasonography in the diagnosis of fetal congenital heart disease. Chin J Birth Health Hered 2003; 11: 119-120 [Article in Chinese]
• 13 Feng YF. Ultrasonographic manifestation of fetal cardiac myxoma: a case report. Chin J Ultrasound Med 2008; 24: 34 [Article in Chinese]
• 14 Huang XZ, Chen FJ, Zhao Z. Ultrasonic diagnosis of fetal multiple ventricular myxoma: a case report. Chin J Ultrasound Diagn 2004; 5: 805-806 [Article in Chinese]
• 15 Jin D, Wang W. Echocardiographic diagnosis of case of fetal cardiac myxoma. Eleventh National Symposium on Echocardiography and International Symposium on New Technologies, 28 December 2012. Harbin, China. pp. 305 [Chinese abstract].
• 16 Liu WF, Mu ST. Color Doppler echocardiography in the diagnosis of fetal cardiac myxoma: a case report. Chin J Med Imaging Tech 2004; 20: 567 [Article in Chinese]
• 17 Luo QC. Fetal right ventricular aneurysm diagnosed by color Doppler ultrasound: a case report. Mod Health (Med Innov Res) 2008; 5: 160 [Article in Chinese]
• 18 Trivedi N, Levy D, Tarsa M. et al. Congenital cardiac anomalies: prenatal readings versus neonatal outcomes. J Ultrasound Med 2012; 31: 389-399
• 19 Wang BJ, Yang J. Ultrasonic diagnosis of fetal left atrial myxoma prolapsing into the left ventricle: a case report. Chin J Ultrasound Diagn 2002; 3: 398 [Article in Chinese]
• 20 Wang HF, Li XM. Echocardiographic diagnosis of fetal coexisted left and right ventricular myxomas: a case report. Chin J Ultrasound Med 2002; 18: 251-236 [Article in Chinese]
• 21 Wu M. The clinical value of echocardiography in prenatal diagnosis of fetal congenital heart disease. China Foreign Med Treat 2011; 30: 180 [Article in Chinese]
• 22 Xie YK, Han R, Li GM. Ultrasonographic diagnosis of fetal left ventricular myxoma: a case report. Chin J Ultrasound Med 2015; 31: 586 [Article in Chinese]
• 23 Xu LD, Fu SW, Gao WJ. et al. Prenatal ultrasonographic diagnosis of a case of fetal right heart myxoma. Chin J Ultrasonogr 2015; 24: 687 [Article in Chinese]
• 24 Xu Y, Jie LL, Liu QH. et al. Ultrasound diagnosis of a case of fetal cardiac multiple myxomas. J Med Imaging 2005; 15: 556 [Article in Chinese]
• 25 Xu ZY. The value of ultrasonography in the diagnosis of fetal cardiac myxoma. J Med Imaging 2006; 16: 213-214 [Article in Chinese]
• 26 Yu MX, Jiang JH, Yang SM. Ultrasound diagnosis of fetal huge myxoma inside the left ventricle: a case report. Chin J Ultrasound Diagn 2003; 4: 795 [Article in Chinese]
• 27 Zhang H. Prenatal ultrasound diagnosis of right atrial myxoma: a case report. Chin J Obstet Gynecol 1999; 34: 150-151 [Article in Chinese]
• 28 Zhang SG, Chen CY, Wang H. et al. Clinical value of prenatal ultrasound diagnosis of fetal cardiac tumors. Chin J Postgrad Med 2013; 36: 57-58 [Article in Chinese]
• 29 Zhao L, Gao DY, Li HG. et al. A case of fetal atrial myxoma. Chin J Obstet Gynecol 1995; 30: 630 [Article in Chinese]
• 30 Zheng H, Wang ZL, Huang YH. et al. The diagnosis of fetal left ventricular myxoma with two-dimensional echocardiography: a case report. Chin J Ultrasound Med 2000; 16: 446-465 [Article in Chinese]
• 31 Zhou ZY, Chen YZ, Zhou JY. Ultrasound diagnosis of fetal left atrial myxoma: a case report. J Ultras Clin Med 2006; 8: 742 [Article in Chinese]
• 32 Yuan SM. Fetal primary cardiac tumors during perinatal period. Pediatr Neonatol 2017; 58: 205-210
• 33 Nuria López V, Roberto Rodríguez G, Gabriel Vegas G. et al. Tumores cardiacos fetales: diagnóstico ecográfico, evolución y tratamiento. Rev Chil Obstet Ginecol 2011; 76: 147-154 [Article in Spanish]
• 34 Aiello VD, de Campos FP. Cardiac myxoma. Autops Case Rep 2016; 6: 5-7
• 35 Dianzumba SB, Char G. Large calcified right atrial myxoma in a newborn. Rare cause of neonatal death. Br Heart J 1982; 48: 177-179