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Right atrial cardiac rhabdomyoma with premature foramen ovale restriction: A case report.

Li YD, He YH, Li ZA, Wei P - Oncol Lett (2014)

Bottom Line: However, this benign tumor can cause hemodynamic repercussions and intrauterine fetal mortality.Fetal mortality subsequently occurred late in the second trimester of pregnancy and the diagnosis was confirmed by pathology.The present study discusses the occurrence and diagnosis of this rare abnormality.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.

ABSTRACT
Fetal cardiac rhabdomyoma is the most common cardiac tumor in fetuses. However, this benign tumor can cause hemodynamic repercussions and intrauterine fetal mortality. The present study reports a case of rare fetal cardiac rhabdomyoma located in the right atrium, accompanied by premature restriction of the foramen ovale and moderate pericardial effusion, as determined by tomographic ultrasound imaging (TUI). Fetal mortality subsequently occurred late in the second trimester of pregnancy and the diagnosis was confirmed by pathology. The present study discusses the occurrence and diagnosis of this rare abnormality. TUI mode with spatio-temporal image correlation offline imaging provides the physician with clear views of abnormal intracardiac structures in the beating heart. With improvements in sonographic technology, the diagnosis of fetal cardiac rhabdomyoma may be easier and more accurate in the clinical arena.

No MeSH data available.


Related in: MedlinePlus

Hematoxylin and eosin (H&E) staining. The image under a light microscope revealed evidence of nodular hyperplasia with clear boundaries, swirl-like cells, cords and a random orientation. The cells possessed a strong eosinophilic cytoplasm, with a slightly increased nuclear size and chromatin condensation (arrows). However, atypia was not remarkable. H&E, original magnification (A) ×200 and (B) ×400.
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f3-ol-08-06-2553: Hematoxylin and eosin (H&E) staining. The image under a light microscope revealed evidence of nodular hyperplasia with clear boundaries, swirl-like cells, cords and a random orientation. The cells possessed a strong eosinophilic cytoplasm, with a slightly increased nuclear size and chromatin condensation (arrows). However, atypia was not remarkable. H&E, original magnification (A) ×200 and (B) ×400.

Mentions: A 30-year-old female, gravid 2 para 0, was referred to the Department of Ultrasound, Beijing Anzhen Hospital (Beijing, China), following a routine prenatal ultrasound examination at Cangzhou City Maternal and Child Care Service Centre (Cangzhou City, China) where pericardial effusion (PE) was detected. The patient had previously suffered a spontaneous abortion at 11 weeks of pregnancy two years ago and the reasons for this remained unclear. Two-dimensional (2D) and three-dimensional (3D) ultrasound imaging was performed using the Voluson E8 ultrasound system (4–8 MHz probe; GE Healthcare, Cleveland, OH, USA). The evaluation demonstrated a single live intrauterine pregnancy of 26 weeks. The fetal echocardiography four-chamber view assessment demonstrated a 6.3-mm thickening of the right atrial wall. Moderate PE was also observed. Color Doppler imaging indicated a narrow foramen ovale flow of only 1.9 mm in diameter (Fig. 1). A bicaval view revealed superior vena cava and inferior vena cava diameters of 3.0 mm and 3.4 mm, respectively. The patient was informed of the possibility of fetal abnormalities and asked to attend weekly follow-ups. However, the patient did not feel quickening two days later and fetal mortality was diagnosed by fetal echocardiography. An autopsy of the fetus revealed that the heart was slightly enlarged, with a subendocardial nodule of 4.3×4.0 mm in size located in the right atrium. The nodule was sharply demarcated, exhibiting a reddish-gray color with a moderately firm texture and the typical appearance of a rhabdomyoma (Fig. 2). Histological hematoxylin and eosin staining revealed nodular hyperplasia with clear boundaries, swirl-like cells, cords and a random orientation. The tumor cells possessed a strong eosinophilic cytoplasm, with slightly increased nuclear size and chromatin condensation. However, atypia was not evident (Fig. 3A and B). The images were reviewed offline by tomographic ultrasound imaging (TUI) and spatio-temporal image correlation (STIC) imaging, which clearly displayed a 5.0×4.0-mm mass located in the right atrial wall area (Fig. 4). No major or minor manifestations of tuberous sclerosis or other notable family histories were documented.


Right atrial cardiac rhabdomyoma with premature foramen ovale restriction: A case report.

Li YD, He YH, Li ZA, Wei P - Oncol Lett (2014)

Hematoxylin and eosin (H&E) staining. The image under a light microscope revealed evidence of nodular hyperplasia with clear boundaries, swirl-like cells, cords and a random orientation. The cells possessed a strong eosinophilic cytoplasm, with a slightly increased nuclear size and chromatin condensation (arrows). However, atypia was not remarkable. H&E, original magnification (A) ×200 and (B) ×400.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214446&req=5

f3-ol-08-06-2553: Hematoxylin and eosin (H&E) staining. The image under a light microscope revealed evidence of nodular hyperplasia with clear boundaries, swirl-like cells, cords and a random orientation. The cells possessed a strong eosinophilic cytoplasm, with a slightly increased nuclear size and chromatin condensation (arrows). However, atypia was not remarkable. H&E, original magnification (A) ×200 and (B) ×400.
Mentions: A 30-year-old female, gravid 2 para 0, was referred to the Department of Ultrasound, Beijing Anzhen Hospital (Beijing, China), following a routine prenatal ultrasound examination at Cangzhou City Maternal and Child Care Service Centre (Cangzhou City, China) where pericardial effusion (PE) was detected. The patient had previously suffered a spontaneous abortion at 11 weeks of pregnancy two years ago and the reasons for this remained unclear. Two-dimensional (2D) and three-dimensional (3D) ultrasound imaging was performed using the Voluson E8 ultrasound system (4–8 MHz probe; GE Healthcare, Cleveland, OH, USA). The evaluation demonstrated a single live intrauterine pregnancy of 26 weeks. The fetal echocardiography four-chamber view assessment demonstrated a 6.3-mm thickening of the right atrial wall. Moderate PE was also observed. Color Doppler imaging indicated a narrow foramen ovale flow of only 1.9 mm in diameter (Fig. 1). A bicaval view revealed superior vena cava and inferior vena cava diameters of 3.0 mm and 3.4 mm, respectively. The patient was informed of the possibility of fetal abnormalities and asked to attend weekly follow-ups. However, the patient did not feel quickening two days later and fetal mortality was diagnosed by fetal echocardiography. An autopsy of the fetus revealed that the heart was slightly enlarged, with a subendocardial nodule of 4.3×4.0 mm in size located in the right atrium. The nodule was sharply demarcated, exhibiting a reddish-gray color with a moderately firm texture and the typical appearance of a rhabdomyoma (Fig. 2). Histological hematoxylin and eosin staining revealed nodular hyperplasia with clear boundaries, swirl-like cells, cords and a random orientation. The tumor cells possessed a strong eosinophilic cytoplasm, with slightly increased nuclear size and chromatin condensation. However, atypia was not evident (Fig. 3A and B). The images were reviewed offline by tomographic ultrasound imaging (TUI) and spatio-temporal image correlation (STIC) imaging, which clearly displayed a 5.0×4.0-mm mass located in the right atrial wall area (Fig. 4). No major or minor manifestations of tuberous sclerosis or other notable family histories were documented.

Bottom Line: However, this benign tumor can cause hemodynamic repercussions and intrauterine fetal mortality.Fetal mortality subsequently occurred late in the second trimester of pregnancy and the diagnosis was confirmed by pathology.The present study discusses the occurrence and diagnosis of this rare abnormality.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P.R. China.

ABSTRACT
Fetal cardiac rhabdomyoma is the most common cardiac tumor in fetuses. However, this benign tumor can cause hemodynamic repercussions and intrauterine fetal mortality. The present study reports a case of rare fetal cardiac rhabdomyoma located in the right atrium, accompanied by premature restriction of the foramen ovale and moderate pericardial effusion, as determined by tomographic ultrasound imaging (TUI). Fetal mortality subsequently occurred late in the second trimester of pregnancy and the diagnosis was confirmed by pathology. The present study discusses the occurrence and diagnosis of this rare abnormality. TUI mode with spatio-temporal image correlation offline imaging provides the physician with clear views of abnormal intracardiac structures in the beating heart. With improvements in sonographic technology, the diagnosis of fetal cardiac rhabdomyoma may be easier and more accurate in the clinical arena.

No MeSH data available.


Related in: MedlinePlus