Special considerations on primary cardiac tumors in infancy and childhood

Primary cardiac tumors are rare at all ages and are even less common in infants and children. In the vast majority of cases, they are benign tumors that show little tendency to growth. Primary malignant tumors of the heart are exceptionally rare. Rhabdomyomas are the most common type of tumors in infants, followed in frequency by the fibromas and the teratomas. Myxomas are very rare in pediatric patients. Symptoms that derive from the presence of a neoplastic mass are usually due to obstruction or compression. In young symptomatic patients, usually affected by rhabdomyomas, there is little chance of survival without surgery. On the other hand several patients with cardiac neoplasms are totally asymptomatic. The indication for surgery is differenciated according to the severity of the clinical picture. Since 1974, 15 infants with a cardiac tumor have been observed in our hospital. Our recent experience with 5 cases, which are described in this report, confirm our opinion, that the most important fact is the restoration of the best possible heart function. Total resection of a tumor should not always be the main therapeutical aim. Surgical intervention is required for those patients, who develop relevant clinical symptoms. Close observation of the clinical course is mandatory in all patients with a doubtful indication for operation.