Spontaneous regression of cardiac rhabdomyoma

Cardiac rhabdomyomas are benign tumors found in the heart. They are the most common heart tumors seen in children and occur in 30 percent of children suffering from tuberous sclerosis. It has been thought that children born with these tumors have a poor prognosis, but most findings are from samples taken from children who have died and thus had severe cases. Many children may have had such tumors that were never recognized. A few reports have found evidence that these tumors have regressed or disappeared on their own in some cases. Echocardiography, a noninvasive technique for examining the heart by using ultrasound, has allowed for greater diagnosis of the incidence and for long-term monitoring of this problem. This study examined the possibility of tumor regression by using echocardiography. Five infants, diagnosed at birth with tuberous sclerosis and cardiac rhabdomyomas, were examined over a period of time to examine tumor progression. Initial evaluation found single masses in two patients and multiple tumors in three, for a total of 13 tumors. The circumferences of the tumors ranged from 0.5 to 10.8 cm. The patients were followed for up to 12.5 years. None of the patients experienced symptoms caused by the tumors. Four of the tumors increased briefly, but these all regressed. All but one of the tumors showed significant decreases in size over time, with 10 of 13 disappearing completely. These results indicate that such tumors are likely to regress and that they should not be operated on unless they are causing severe side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)