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

OBJECTIVE

To investigate the influence of corticotropin therapy on cardiac rhabdomyoma.

DESIGN

Analysis of data from echocardiography performed on in-patients.

PATIENTS: 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.

INTERVENTION: 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.

MAIN RESULT: 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.

CONCLUSION

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