Cuillier F, MD*, Lemaire P, Deshayes M**

* Department of Gynecology, Félix Guyon´Hospital  ** Sonographer, Moufia´street, Ile de la Réunion, France.

Case report: This is a 25-year-old woman, gravida 2, para 1, referred to our service at 35 weeks. The first trimester scan including the nuchal translucency and the anomaly scan were normal. The triple test was not performed.  At 35 weeks, the scan revealed multiple solid well delimited echogenic masses inside the heart, suggestive of  cardiac rhabdomyomas.  The patient was evaluated again at 36 weeks and the ultrasound findings were:

• Large rhabdomyoma with a diameter of 13 X 8 mm, located within the interventricular septum
• Another rhabdomyoma located at the ventricular apex, measuring 10 X 8 mm
• Multiples small tumors, located in both ventricular walls, near the apex and in the right and left wall
• Normal cardiac anatomy
• Aortic and pulmonary valves were not obstructed
• Color Doppler imaging showed no sign of obstructive flow or valvular regurgitation
• Real-time M-mode scan revealed a regular rhythm.
• No extra-cardiac anomalies were detected
• The brain seemed normal.

At 37 weeks, a cerebral MRI was performed. There were no tumors on the brain. The baby was born at 37 weeks (2600 g). The postnatal ECG was normal. Postnatal echocardiography confirmed the prenatal findings. The patient did not have any external sign of tuberous sclerosis.

Note multiples tumors located in the ventricular walls and in the intraventricular septum.