Annals of Pediatric Cardiology · Published 2026-03-01 · DOI 10.4103/apc.apc_237_25
Fetal cardiac rhabdomyoma is the most common prenatal cardiac tumor and is frequently associated with tuberous sclerosis complex (TSC). Everolimus, a mammalian target of rapamycin inhibitor, is an established postnatal therapy for TSC-related tumors, but its prenatal use remains rare. A 27-year-old primigravida was referred at 21 weeks’ gestation for evaluation of a left ventricular mass. Given the rapid, severe progression of tumor size, maternal oral everolimus therapy was initiated at 28 weeks, with dose titration to achieve drug levels of 3–8 ng/ml. At 32 weeks, the tumor size regressed significantly. Neonatal serum everolimus on day 1 was 5.2 ng/mL, confirming transplacental transfer. Therapy was resumed postnatally, and at 5 months, the tumor had completely resolved, with normal neurodevelopment and no seizures. While short-term safety and efficacy of prenatal everolimus therapy are promising, further studies are needed to establish standardized dosing, safety profiles, and long-term developmental outcomes.
Abstract from DOAJ. Public domain (CC0 1.0).
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