Cardiac Rhabdomyoma (CR) is the most common neonatal heart tumor. It is a kind of benign sarcoma (Harmatoma). If it is small and it only appears in unimportant sites, it only needs to be carefully followed and most tumors can subside after two years of age. However, when a CR is too large and occupied the main bloodstream entrance of the heart, it will endanger the life of the newborn!
Director Jeng-Sheng Chang of Department of Pediatric Cardiology at China Medical University Children’s Hospital indicates that the treatment of this kind of life-threatening CR in the past was to perform the high-risk neonatal open-heart surgery to remove these sarcomas. Till 2012, Pediatrics published the world’s first successful case of drug treatment. An infant with CR was treated with an immunosuppressant, Everolimus, and dismissed from the risk of surgery. Coincidentally, since 2014, China Medical University Children’s Hospital has consecutively treated three newborns with giant CR and used Everolimus to successfully subside their tumors in two months. They happily discharged and are above two-year of age now.
Director Chang indicates that in the early stage of treatments, the active treatment of pediatric intensive care units (PICU) is very much needed. One case of the newborns was transferred to Children’s Hospital and found that his tumor had occupied the entire left ventricle and both the mitral valve and aortic valve are completely blocked by the tumor; finally, the case had successfully regressed most of the tumors, been removed the tracheal cannula, and discharged within two months.
In the treatment experience of these three cases, the medical team of the Children’s Hospital has found that as long as administrating one-tenth of the original recommended dose, the tumor can be effectively eliminated and drug complications are avoided. At the International Society of Heart Medicine conference held in Singapore last month, Dr. Chang has shared this treatment experience with physicians from all over the world.
Thank the concerted efforts of the Children’s Hospital of Cardiology, Critical Care, Nephrology, Neurology, and Pharmacy, we jointly confirmed a successful treatment that “Regression of Neonatal Cardiac Rhabdomyoma through Low Dose Everolimus Therapy in Two Months”
Jeng-Sheng Chang, Director,
Department of Pediatric Cardiology,
China Medical University Children’s Hospital