Rapid enlargement of cardiac rhabdomyoma during corticotropin therapy for infantile spasms.

OBJECTIVE

To investigate the influence of corticotropin therapy on cardiac rhabdomyoma.

METHODS

Analysis of data from echocardiography performed on in-patients.

METHODS

Six patients with rhabdomyoma who were admitted to the authors' medical centre with either convulsion (five cases) or prematurity (one case) between 1985 and 1995. Five had tuberous sclerosis.

METHODS

Size of cardiac tumours of each patient was measured by echocardiography, and volume index was calculated as the ratio of the tumour volume to its initial volume.

RESULTS

Increase in size of some of the tumours was found during corticotropin therapy on follow-up echocardiography. Maximum volume indexes of tumours in the case of patients (n = 4) who did not receive corticotropin therapy was 1.2 to 3.7, whereas those of patients (n = 2) who received therapy was 9.1 to 12; one of the latter patients died.

CONCLUSIONS

Corticotropin may contribute to the enlargement of cardiac rhabdomyoma. The size of cardiac rhabdomyomas must be carefully followed when patients are treated with corticotropin.