Pediatric Cardiac Rhabdomyoma

  • Etiology: Benign hamartomatous lesion of cardiac muscle tissue
  • Imaging: Arise anywhere in myocardium but most commonly in left ventricle
  • Imaging US: Solid hyperechoic mass
  • Imaging MRI:
    — T1WI: Isointense to myocardium
    — T2WI: Hyperintense to myocardium
  • DDX:
  • Complications: Left ventricle outflow obstruction, refractory arrhythmias
  • Treatment: Most regress spontaneously, surgery if symptomatic
  • Clinical:
    — Most common cardiac tumor in pediatric population
    — Majority are asymptomatic but may present with left ventricle outflow obstruction or refractory arrhythmias
    — 50% of tumors found in patients later diagnosed with tuberous sclerosis

Radiology Cases of Cardiac Rhabdomyoma

CT of cardiac rhabdomyoma
CXR AP (above left) shows cardiomegaly. Coronal CT with contrast of the chest (above right) shows a large low density nonenhancing mass inside the heart which on axial CT (below left) appears to be in the right ventricle and on sagittal CT (below right) appears to be encroaching on the right ventricular outflow tract.