Foetal cardiac rhabdomyoma due to paternal TSC1 Mutation: a case report and literature review

Abstract

Rhabdomyomas are the most common prenatal cardiac tumours, and are often associated with tuberous sclerosis complex (TSC). They have been shown to grow during foetal development, but may often regress or shrink in early childhood. In the present case, ultrasonography at 20+2 gestational weeks identified two echogenic masses suspicious of rhabdomyomas in the foetal heart. Neither of these tumours caused significant haemodynamic instability. Genetic testing of DNA extracted from amniocytes revealed a pathogenic variant of the TSC1 gene, supporting the diagnosis of tuberous sclerosis. The pregnancy was terminated at 21+1 weeks. Pathological examination confirmed the presence of two cardiac rhabdomyomas, histologically characterised by distinctive large vacuolated cells with central nuclei and radial cytoplasmic extensions. Further research and a multidisciplinary approach are highly recommended to improve management and outcomes of prenatal tumours.