Pediatric primary cardiac tumors: diagnosis and treatment

Area of Science:

• Pediatric Cardiology
• Fetal and Neonatal Medicine
• Pediatric Oncology

Background:

• Primary cardiac tumors are uncommon in children.
• Clinical manifestations vary significantly across pediatric age groups, from fetus to young adult.
• This review focuses on specific tumors: rhabdomyomas, fibromas, myxomas, and pericardial teratomas in fetuses and neonates.

Purpose of the Study:

• To outline the diagnostic approaches for fetal and neonatal primary cardiac tumors.
• To describe the management strategies for these rare pediatric conditions.
• To emphasize the importance of specialized care in tertiary centers.

Main Methods:

• Review of diagnostic methods including echocardiography for fetal diagnosis.
• Discussion of clinical presentations prompting neonatal diagnosis (murmur, dysrhythmia, obstruction).
• Outline of emergent interventions and surgical considerations.

Main Results:

• Fetal diagnosis is possible for rhabdomyomas, fibromas, and pericardial teratomas, often linked to specific fetal conditions.
• Neonatal diagnosis may be triggered by symptoms of cardiac compromise or obstruction.
• Prenatal diagnosis of significant masses requires immediate neonatal intensive care and potential interventions like prostaglandin E(1) or balloon atrial septostomy.

Conclusions:

• Referral to a tertiary center is essential for comprehensive evaluation and management of fetal and neonatal cardiac tumors.
• Prompt multidisciplinary intervention, including advanced life support and potential surgery, is critical for neonates with hemodynamically significant tumors.
• Early diagnosis and management significantly impact the prognosis for pediatric patients with primary cardiac tumors.