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[Pericardial effusion in neoplasms and malignant hemopathies in children. Study of 12 cases and pathogenetic
G Balducci1, N Santoro, P Caliandro
1Istituto di Pediatria Clinica e Preventiva dell'Università di Bari, Italia.
Insights
Pericardial effusion (P.E.) is uncommon in pediatric cancers, detected in 5.7% of cases via echocardiography. Early diagnosis and treatment of P.E. are crucial for improving outcomes in children with leukemia and solid tumors.
Area of Science:
- Pediatric Oncology
- Cardiology
- Diagnostic Imaging
Context:
- Pericardial effusion (P.E.) is a known complication of malignancies and leukemia.
- The frequency of P.E. in pediatric cancer patients is not well-established.
- Echocardiography enables detection of small P.E.s.
Purpose:
- To determine the frequency of P.E. in children with malignant neoplasms and leukemia.
- To evaluate the utility of echocardiography in diagnosing P.E. in this population.
- To assess the clinical presentation and management of P.E. in pediatric cancer patients.
Summary:
- A total of 265 echocardiograms were performed in 210 children with cancer or leukemia between 1981 and 1985.
- 12 cases (5.7%) of P.E. were identified, most commonly in acute lymphatic leukemia (ALL) and rhabdomyosarcoma.
- P.E. was often detected early, with some cases resolving after chemotherapy. Malignant cells were found in one patient's pericardial fluid.
Impact:
- Echocardiography is effective in identifying P.E. in pediatric cancer patients.
- P.E. occurs in a small but significant percentage of children with malignancies.
- Findings highlight the importance of cardiac monitoring in pediatric cancer treatment.
Abstract:
Pericardial effusion (P.E.) has been described during the course of malignant neoplasms and leukemia, but in children its frequency is not well-known. It is possible by echocardiography to identify very small P.E. M-mode echocardiograms were performed for periodic evaluation of the patients treated by antraciclinic drugs and when P.E. was suspected by the physical examination, chest roentgenogram and electrocardiographic data. A total of 265 echocardiograms were performed in 210 children with malignant neoplasms and leukemia from 1981 to 1985 and 12 cases (5.7%) of P.E. were identified: 7 affected by acute lymphatic leukemia (ALL), 3 Rhabdomyosarcoma, 1 by Wilm's tumor and 1 by Ewing's sarcoma. In all patients was carried out and Ecg, and a chest roentgenogram was performed to evaluate cardiac shadow. Hemoglobin, serum protein and VES values were evaluated to control, respectively, anemia, dysprotidemia and flogistic condition. Pericardiocentesis was played when clinical findings indeed. P.E. was identified in 6 out all cases, 4 affected by ALL and 2 by Rhabdomyosarcoma, during the first clinical approach. Two cases, both affected by ALL, showed large P.E., x-ray enlarged cardiac shadow and typical electrocardiographic findings. The disappearance of the P.E., resulted few days after the beginnings of antiblastic therapy. Four cases were in maintenance therapy: 2 affected by ALL, 1 Ewing's sarcoma and 1 by Rhabdomyosarcoma. The last two showed very large P.E. and pericardiocentesis was necessary: only in patient with rhabdomyosarcoma fluid containing malignant cells was yielded, and reproducing itself one day after.(ABSTRACT TRUNCATED AT 250 WORDS)