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Primary cardiac tumours: when is surgery necessary?

B Stiller1, R Hetzer, R Meyer

  • 1Department of Pediatric Cardiology, Deutsches Herzzentrum, Augustenburger Platz 1D-13353, Berlin, Germany. stiller@dhzb.de

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|October 25, 2001
PubMed
Summary

Pediatric cardiac tumors are often benign and may regress spontaneously. Surgery is reserved for symptomatic cases, focusing on heart function restoration rather than complete resection.

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Area of Science:

  • Pediatric Cardiology
  • Pediatric Cardiac Surgery
  • Developmental Biology

Background:

  • Primary cardiac tumors are rare in children, with limited long-term data compared to adult myxomas.
  • Improved fetal ultrasonography leads to earlier detection of pediatric cardiac tumors.
  • Distinguishing between surgical and conservative management for pediatric cardiac tumors presents a clinical challenge.

Purpose of the Study:

  • To analyze the presentation, characteristics, and outcomes of primary cardiac tumors in a pediatric cohort.
  • To evaluate the efficacy of surgical versus conservative management strategies.
  • To identify factors predicting tumor behavior, including spontaneous regression.

Main Methods:

  • Retrospective review of 51 cardiac tumors in 26 children over a 10-year period.

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  • Analysis included tumor presentation, location, histology, interventions, and clinical course.
  • Median patient age was 1 month.

    • Main Results:

    • Rhabdomyomas were the most common (29 cases), followed by fibromas (9).
    • Tumors frequently occurred in the ventricles, presenting with murmurs, arrhythmias, or outflow tract obstruction.
    • Surgical intervention was performed in 14 children with hemodynamic compromise; 9 rhabdomyomas showed spontaneous regression.

    Conclusions:

    • Most pediatric cardiac tumors are benign, with potential for spontaneous regression beyond rhabdomyomas.
    • Surgical intervention is indicated for clinically significant symptoms, not solely for tumor removal.
    • Restoring optimal cardiac function is the primary therapeutic goal, superseding complete resection.