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Primary cardiac tumours in the paediatric population
Lucio Careddu1, Guido Oppido, Francesco Dimitri Petridis
1Pediatric Cardiac Surgery and GUCH Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Insights
Primary cardiac tumors in children are rare but can cause serious symptoms from fetal life onward. Surgical intervention is key for symptomatic cases, with prognosis depending on tumor type and strict follow-up essential.
Area of Science:
- Pediatric Cardiology
- Pediatric Oncology
- Cardiovascular Surgery
Background:
- Primary cardiac tumors are uncommon in children, presenting diverse symptoms in fetal and postnatal stages.
- Manifestations range from arrhythmias and heart failure in utero to cyanosis, respiratory distress, and sudden death postnatally.
- These tumors significantly impact pediatric cardiovascular health.
Purpose of the Study:
- To summarize the clinical presentation, management, and outcomes of primary cardiac tumors in the pediatric population.
- To highlight the importance of surgical intervention and long-term follow-up for pediatric cardiac neoplasms.
- To differentiate prognostic factors based on tumor histology.
Main Methods:
- Review of clinical data for pediatric patients diagnosed with primary cardiac tumors.
- Analysis of presenting symptoms, diagnostic methods, treatment strategies, and patient outcomes.
- Correlation of tumor characteristics with prognosis and recurrence rates.
Main Results:
- Cardiac tumors in children can manifest with varied symptoms, including fetal hydrops, arrhythmias, heart failure, and postnatal cyanosis or obstruction.
- Surgical treatment is the primary therapeutic approach for symptomatic tumors, while medical therapy is palliative.
- Prognosis is generally favorable for benign tumors but poor for malignant neoplasms, necessitating vigilant surveillance for recurrence.
Conclusions:
- Primary cardiac tumors in children require prompt diagnosis and management, often involving surgical resection.
- Long-term follow-up is crucial for all pediatric patients with cardiac neoplasms to monitor for potential recurrence.
- Understanding tumor type and patient characteristics is vital for predicting outcomes and guiding treatment decisions.
Abstract:
Primary cardiac tumours are relatively rare in the paediatric population, and they may occur with different signs and symptoms in foetal or post-natal life. The clinical manifestations of cardiac tumours in foetal life may include arrhythmias, congestive heart failure and hydrops. In post-natal life, cardiac tumours may cause cyanosis, respiratory distress, myocardial dysfunction, valvular insufficiency, arrhythmias, inflow or outflow tract obstructions and sudden death. Surgical treatment is essential when symptoms are present, while the role of medical therapy can merely be palliative. Results are various and related to the patients' and tumour characteristics. Primary benign heart tumours mainly have a good prognosis, while malignant neoplasms usually have a poor prognosis; in both cases, however, a strict follow-up is always mandatory in order to detect the recurrence of cardiac neoplasms after surgery.
