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Neonatal tuberculosis and cardiac inflammatory myofibroblastic tumor
Maria Niña F Banque1, Ramon O Ribu, Maria Theresa T Policarpio
1Division of Pulmonary and Critical Care Medicine, Section of Pediatric Pulmonology, Philippine Heart Center, Quezon City, Philippines.
Insights
A rare inflammatory myofibroblastic tumor in a neonate with respiratory distress resolved completely after antituberculosis medication. This case highlights tuberculosis as a potential cause of cardiac masses in infants.
Area of Science:
- Pediatric Cardiology
- Pediatric Oncology
- Infectious Diseases
Background:
- Inflammatory myofibroblastic tumors (IMTs) are rare neoplasms of uncertain malignant potential.
- Cardiac IMTs are exceptionally rare, particularly in neonates, presenting diagnostic and therapeutic challenges.
Observation:
- A 1-month-old neonate presented with respiratory distress and was found to have an anterior cardiac mass near the left ventricle and right ventricular outflow tract via echocardiography and CT scan.
- Biopsy confirmed inflammatory myofibroblastic tumor. Concurrently, a positive tuberculin test and positive results in three household contacts indicated active tuberculosis.
Findings:
- The patient received antituberculosis medication.
- After one year of treatment, follow-up echocardiography and CT scans demonstrated complete resolution of the cardiac mass.
Implications:
- This case suggests that tuberculosis should be considered in the differential diagnosis of cardiac masses in neonates, especially in endemic areas.
- Successful treatment of tuberculosis led to the complete resolution of the inflammatory myofibroblastic tumor, indicating a potential infectious etiology for this tumor type in this specific context.
Abstract:
A 1-month-old neonate was admitted in respiratory distress. Two-dimensional echocardiography and computed tomography scan showed a mass anterior to the left ventricle and right ventricular outflow tract. A biopsy revealed an inflammatory myofibroblastic tumor. A tuberculin test showed an 18-mm diameter induration. Three of the 6 household contacts were also positive for pulmonary tuberculosis. Antituberculosis medication was started. After 1 year, echocardiography and computed tomography scan showed complete resolution of the mass.
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