Image in Cardiology
Fetal giant cardiac tumor
Tumor cardíaco gigante no feto
Inês C. Mendes
, Ana Rita Araújo, Rui Anjos, Ana Teixeira
Corresponding author
Pediatric Cardiology Department, Hospital de Santa Cruz, Carnaxide, Portugal
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Mendes, Ana Rita Araújo, Rui Anjos, Ana Teixeira" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Inês C." "apellidos" => "Mendes" "email" => array:1 [ 0 => "inescarmomendes@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ana Rita" "apellidos" => "Araújo" ] 2 => array:2 [ "nombre" => "Rui" "apellidos" => "Anjos" ] 3 => array:2 [ "nombre" => "Ana" "apellidos" => "Teixeira" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Pediatric Cardiology Department, Hospital de Santa Cruz, Carnaxide, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Tumor cardíaco gigante no feto" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1035 "Ancho" => 2500 "Tamanyo" => 270972 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Fetal echocardiogram at 35 weeks of gestation (4-chamber view): single cardiac mass adjacent to the left ventricle (57 mm×43 mm), with well-defined contours and homogeneous echogenicity, mild left ventricular compression and moderate pericardial effusion (arrows). LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The authors report the case of a 29-year-old woman with an uneventful pregnancy until 35 weeks of gestational age, when a single fetal giant cardiac mass and moderate pericardial effusion were detected on a routine fetal obstetric scan. The mass measured 57 mm×43 mm and was adjacent to the anterior and lateral walls of the left ventricle, causing mild compression, with no signs of inflow or outflow tract obstruction (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>, <a class="elsevierStyleCrossRef" href="#sec0035">Videos 1-3</a>). Global cardiac function was preserved and no signs of hemodynamic compromise were documented. All findings were considered consistent with a single cardiac rhabdomyoma.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Considering the risk of hemodynamic compromise and interference with lung development, a multidisciplinary decision was made to deliver at 36 weeks by cesarean section. The patient was born in good condition and no hemodynamic compromise or other organ lesions were ever documented. A conservative approach was taken and the patient remained completely asymptomatic, clinically stable under diuretic therapy, gaining weight, with significant regression of pericardial effusion and tumor dimensions documented over time (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 2</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Despite the tumor's massive size and location, almost as large as the whole heart and adjacent to the left ventricle, the clinical course was excellent, with documented tumor reduction and no need for intervention.</p><p id="par0020" class="elsevierStylePara elsevierViewall">When established, antenatal diagnosis enables a focused specialized and multidisciplinary approach with individual case management, potentially reducing perinatal morbidity and mortality.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-07-26" "fechaAceptado" => "2016-09-02" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Videos 1-3</span> Very well-delimited single fetal giant cardiac mass with homogenous echogenicity, adjacent to the anterior and lateral walls of the left ventricle, measuring 57 mm×43 mm, with moderate to severe pericardial effusion. No inflow or outflow tract obstruction is seen and global cardiac function is preserved.<elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia><elsevierMultimedia ident="upi0015"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary material" "identificador" => "sec0035" ] ] ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1035 "Ancho" => 2500 "Tamanyo" => 270972 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Fetal echocardiogram at 35 weeks of gestation (4-chamber view): single cardiac mass adjacent to the left ventricle (57 mm×43 mm), with well-defined contours and homogeneous echogenicity, mild left ventricular compression and moderate pericardial effusion (arrows). LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle.</p>" ] ] 1 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2114 "Ancho" => 2500 "Tamanyo" => 324132 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Echocardiograms comparing day 1 of life (above) and last review at nine months of age (below) showing significant regression of the tumor and no pericardial effusion.</p>" ] ] 2 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 2000924 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 3 => array:5 [ "identificador" => "upi0010" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc2.mp4" "ficheroTamanyo" => 1966643 "Video" => array:2 [ "mp4" => array:5 [ "fichero" => "mmc2.m4v" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "flv" => array:5 [ "fichero" => "mmc2.flv" "poster" => "mmc2.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 4 => array:5 [ "identificador" => "upi0015" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc3.mp4" "ficheroTamanyo" => 1735482 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc3.flv" "poster" => "mmc3.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:5 [ "fichero" => "mmc3.m4v" "poster" => "mmc3.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003600000009/v1_201709220127/S2174204917302465/v1_201709220127/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000009/v1_201709220127/S2174204917302465/v1_201709220127/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917302465?idApp=UINPBA00004E" ]
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