Fetal Cardiac Tumors

Ashish Jain, Gazala Shahnaz

Case Scenario

A 25-year-old gravida 2 at 32 weeks of gestation was referred for antenatal ultrasound (USG) screening. The evaluation was suggestive of a hyperechoic lesion of size 23 × 23 mm in the left ventricle of the fetal heart. On a further detailed re-evaluation, a few small hyperechoic tumors were also seen in the other parts of the fetal heart. There were no other gross congenital anomalies noted. On serial fetal echocardiographies (FEs), no further increase in the size of the tumors was observed, and there was no sign of fetal arrhythmia or hydrops.

Conclusions

Fetal cardiac tumors are rare and in most cases are benign; however, they may cause a series of cardiovascular events such as intracardiac flow obstruction, heart valve insufficiency, arrhythmia, heart failure, and hydrops fetalis, or even sudden fetal death. FE plays an important role in the antenatal diagnosis of tumors. Therapeutic options for symptomatic fetuses depending on the actual fetal conditions include elective delivery, intrauterine pericardiocentesis, thoracoamniotic shunt, and antenatal or postnatal open tumor resection. After the treatment, the fetuses may exhibit an improved cardiac function with a prolonged life expectancy.