Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-10T08:18:05.304Z Has data issue: false hasContentIssue false

Rapid response of a cardiac rhabdomyoma causing severe right ventricular outflow obstruction to Sirolimus in an infant with negative genetics for Tuberous sclerosis

Published online by Cambridge University Press:  05 November 2020

Yifat Nir-David
Affiliation:
Paediatric Cardiology and Congenital Heart Disease in Adults, The Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa3109601, Israel Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
Sharon Brosilow*
Affiliation:
Paediatric Cardiology and Congenital Heart Disease in Adults, The Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa3109601, Israel Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
Asaad Khoury
Affiliation:
Paediatric Cardiology and Congenital Heart Disease in Adults, The Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa3109601, Israel Ruth and Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
*
Author for correspondence: Dr S. Brosilow, Paediatric Cardiology and Congenital Heart Disease in Adults, Rambam Health Care Campus, PO box 387, Kibbutz Ramot Menashe, Haifa 1924500 Israel. Tel: +972-52-4589778; Fax: +972-47-774960. E-mail: Sharon.brosilow@gmail.com

Abstract

Mammalian target of rapamycin inhibitors was found recently to be an effective treatment for manifestations of Tuberous sclerosis complex, including cardiac rhabdomyomas. Most cases with Cardiac rhabdomyoma treated with mammalian target of rapamycin inhibitors to date were diagnosed with Tuberous sclerosis. We report a case of cardiac rhabdomyoma and severe right ventricular outflow obstruction in a baby with negative genetics for Tuberous sclerosis that responded rapidly to Sirolimus.

Type
Brief Report
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beghetti, M, Gow, RM, Haney, I, Mawson, J, Williams, WG, Freedom, RM. Pediatric primary benign cardiac tumors: A 15-year review. Am Heart J 1997; 134: 11071114. doi: 10.1016/S0002-8703(97)70032-2 Google ScholarPubMed
Amonkar, GP, Kandalkar, BM, Balasubramanian, M. Cardiac rhabdomyoma. Cardiovasc Pathol 2009; 18: 313314. doi: 10.1016/j.carpath.2008.02.002 CrossRefGoogle ScholarPubMed
Cleary, A, McMahon, CJ. Literature review of international mammalian target of rapamycin inhibitor use in the non-surgical management of haemodynamically significant cardiac rhabdomyomas. Cardiol Young. Published online June 11, 2020: 111. doi: 10.1017/S104795112000147X CrossRefGoogle Scholar
Dahdah, N. Everolimus for the treatment of tuberous sclerosis complex–related cardiac rhabdomyomas in pediatric patients. J Pediatr 2017; 190: 2126.e7. doi: 10.1016/j.jpeds.2017.06.076 CrossRefGoogle ScholarPubMed
Franz, DN, Belousova, E, Sparagana, S, et al. Efficacy and safety of everolimus for subependymal giant cell astrocytomas associated with tuberous sclerosis complex (EXIST-1): a multicentre, randomised, placebo-controlled phase 3 trial. The Lancet 2013; 381: 125132. doi: 10.1016/S0140-6736(12)61134-9 CrossRefGoogle ScholarPubMed
Saffari, A, Brösse, I, Wiemer-Kruel, A, et al. Safety and efficacy of mTOR inhibitor treatment in patients with tuberous sclerosis complex under 2 years of age – a multicenter retrospective study. Orphanet J Rare Dis 2019; 14: 96. doi: 10.1186/s13023-019-1077-6 CrossRefGoogle ScholarPubMed
Ninic, S, Kalaba, M, Jovicic, B, et al. Successful use of sirolimus for refractory atrial ectopic tachycardia in a child with cardiac rhabdomyoma. Ann Noninvasive Electrocardiol 2017; 22: e12435. doi: 10.1111/anec.12435 CrossRefGoogle Scholar
Kotulska, K, Larysz-Brysz, M, Grajkowska, W, et al. Cardiac Rhabdomyomas in Tuberous Sclerosis Complex Show Apoptosis Regulation and mTOR Pathway Abnormalities. Pediatr Dev Pathol 2009; 12: 8995. doi: 10.2350/06-11-0191.1 CrossRefGoogle ScholarPubMed
Chang, J-S, Chiou, P-Y, Yao, S-H, Chou, I-C, Lin, C-Y. Regression of neonatal cardiac rhabdomyoma in two months through low-dose everolimus therapy: a report of three cases. Pediatr Cardiol 2017; 38: 14781484. doi: 10.1007/s00246-017-1688-4 CrossRefGoogle ScholarPubMed
Davis, KA, Dodeja, AK, Clark, A, et al. Use of cardiac MRI to assess antitumor efficacy of everolimus in sporadic cardiac rhabdomyoma. Pediatrics 2019; 143: e20182495. doi: 10.1542/peds.2018-2495 CrossRefGoogle ScholarPubMed