[Intracardiac metastases of primary neuroectodermal tumor]

Cardiac metastases from malignant tumors are rare in children and are usually found only at necropsy.

A girl aged 6 months developed a swelling in the area of her left shoulder. Surgical excision was incomplete and pathological examination indicated neuroectodermic soft-tissue tumor. Chemotherapy with cyclophosphamide, doxorubicin then vincristine and actinomycin D was instituted, followed by second course of cyclophosphamide-doxorubicin. Three months after cessation of chemotherapy, the child developed manifestations of congestive cardiac failure that could not be induced by anthracycline (total cumulative dose: 275 mg/m2). Cardiac ultrasonography showed a metastatic tumor (diam = 3 cm) on the wall of the right ventricle and atrium, which was pedunculated inside the infundibular chamber. It was partly excised, and the patient was treated with etoposide and carboplatin. But a second metastatic tumor formed in the paravertebral area.

This is the first description, to our knowledge, of cardiac metastases from neuroectodermic tumor. They were diagnosed by cardiac ultrasonography, as this imaging technique differentiates this complication from the anthracycline-induced cardiomyopathy usually seen in children developing cardiac failure under chemotherapy.