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(Circulation. 2006;114:e591-e593.)
© 2006 American Heart Association, Inc.

Images in Cardiovascular Medicine

Echocardiographic History of an Asymptomatic Congenital Cardiac Tumor

No Changes in Mass Dimensions During a 14-Year Follow-Up

Andrea Motto, MD; Piercarlo Ballo, MD; Arianna Bocelli, MD; Silvana Gramenzi, MD; Maurizio de Martino, MD

From the Cardiology Operative Unit, S. Andrea Hospital, La Spezia (A.M., P.B.); Department of Pediatrics, University of Florence, Anna Meyer Children’s Hospital, Florence (A.B., M.d.M.); and Department of Cardiology, Fatebenefratelli ed Oftalmico Hospital, Milano (S.G.), Italy.

Correspondence to Dr Piercarlo Ballo, U.O. Cardiologia, Ospedale "S. Andrea," Via Veneto 197, 19100 La Spezia, Italy. E-mail pcballo@tin.it

An extract of the first 250 words of the full text is provided, because this article has no abstract.

A 14-year-old girl with a history of a congenital cardiac tumor presented to our echocardiography laboratory for a routine reexamination. The diagnosis had been made in our laboratory in 1991 on her seventh day of life using an old-generation ultrasound machine (SSH-40A, Toshiba Medical Systems, Tokyo, Japan). The newborn had undergone echocardiographic evaluation because of a systolic murmur. Despite the low technical quality of the images (Figure 1 and Movie I), a large mass involving the interventricular septum (4.2x1.5 cm, as measured from the apical 4-chamber view), suggestive of a congenital cardiac tumor, was visualized. Subsequent analyses had supported the diagnosis of cardiac rhabdomyoma. No other significant comorbidities, including tuberous sclerosis—a genetic condition often associated with the presence of cardiac rhabdomyoma¹—had been discovered. Because of the absence of symptoms, a conservative approach was adopted. Clinical and echocardiographic follow-up during the subsequent years showed substantial tumor stability, with no development of symptoms.

View larger version (111K): [in this window] [in a new window]   Figure 1. Original echocardiographic image obtained in 1991 using an old-generation ultrasound machine and stored using a VHS videotape. Despite the poor quality of the image, a large mass, highly suggestive of a congenital cardiac tumor, was detected within the interventricular septum (white arrow). LV indicates left ventricle; RV, right ventricle.

At the present examination, the girl was asymptomatic and in good condition. Two-dimensional echocardiography (Sonos 7500 Live 3D Echo, Philips Medical Systems, Andover, Mass) showed an inhomogeneous echogenic mass arising from the mid-apical portion of the interventricular septum (Figures 2 to 4). . . . [Full Text of this Article]