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Recurrence of large cardiac rhabdomyoma and pre-excitation syndrome in an infant after sirolimus therapy

Published online by Cambridge University Press:  20 August 2025

Adeola O. Awujoola Open the ORCID record for Adeola O. Awujoola [Opens in a new window] ,
Piers C. Barker Open the ORCID record for Piers C. Barker [Opens in a new window]  and
Michael G.W. Camitta
Adeola O. Awujoola*
Affiliation:
Peditric Cardiology, Duke University, Durham, NC, USA
Piers C. Barker
Affiliation:
Peditric Cardiology, Duke University, Durham, NC, USA
Michael G.W. Camitta
Affiliation:
Peditric Cardiology, Duke University, Durham, NC, USA
*
Corresponding author: Adeola O. Awujoola; Email: adeolaolubukola.awujoola@duke.edu
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Abstract

Cardiac rhabdomyomas are the most common benign paediatric cardiac tumours. Arrhythmias and cardiac conduction abnormalities have both been described with these tumours and resolved with reduction in size of the tumours. Here, we present a case of a child who was prenatally diagnosed with multiple cardiac rhabdomyomas and cardiac arrhythmias and found to have ventricular pre-excitation after birth, in whom the tumours regressed, and pre-excitation resolved with 12 weeks of sirolimus and propranolol therapy. However, 8 weeks after cessation of sirolimus and propranolol therapy, tumour size increased, and manifest ventricular pre-excitation recurred and progressed to ventricular tachycardia. Subsequent follow-up after restarting sirolimus and propranolol therapy showed a significant reduction in tumour burden and resolution of pre-excitation.

Conclusions:

This finding underscores the need for risk stratification among patients with cardiac rhabdomyomas to identify those that need more prolonged medical treatment or closer monitoring.

Keywords

Cardiac rhabdomyomaarrhythmiassirolimus

Information

Type
Case Report
Information
Cardiology in the Young , Volume 35 , Issue 8 , August 2025 , pp. 1746 - 1748
Copyright
© The Author(s), 2025. Published by Cambridge University Press

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