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Congenital cardiac tumors in association with orofacial clefts
L M Back1, A S Brown, L R Barot
1Department of General Surgery, Cooper Hospital/University Medical Center, Camden, NJ.
Insights
This case highlights a rare congenital cardiac fibroma causing failure to thrive in an infant with orofacial clefts. Early diagnosis and a multidisciplinary approach are crucial for managing such complex conditions.
Area of Science:
- Pediatric Cardiology
- Craniofacial Surgery
- Medical Genetics
Background:
- Orofacial clefts, including cleft lip and palate, are common congenital anomalies.
- Congenital heart disease is frequently associated with orofacial clefts.
- Congenital cardiac tumors are rare but serious conditions in infants.
Observation:
- A case is presented of an infant with complete cleft palate and unilateral cleft lip experiencing failure to thrive.
- The infant's failure to thrive was attributed to a primary congenital cardiac fibroma.
- This cardiac fibroma necessitated cardiac transplantation for successful treatment.
Findings:
- A literature review found no reported associations between congenital cardiac tumors and orofacial clefts.
- Failure to thrive in infants with orofacial clefts warrants thorough investigation for underlying cardiac anomalies.
- Congenital cardiac fibromas can be effectively managed with cardiac transplantation.
Implications:
- This case underscores the importance of considering cardiac anomalies, including rare tumors, in infants with orofacial clefts presenting with failure to thrive.
- Two-dimensional echocardiography is a valuable diagnostic tool for identifying cardiac fibromas.
- A multidisciplinary team approach is essential for optimal management of these complex pediatric cases.
Abstract:
The case of an infant with a complete cleft of the primary and secondary palate (class III) and right unilateral complete cleft lip who demonstrated failure to thrive due to a primary congenital cardiac fibroma is described. This tumor required cardiac transplantation for effective treatment. A review of the literature, although replete with associations of cleft lip/palate and congenital heart disease, does not reveal a congenital cardiac tumor/orofacial cleft association or syndrome. Failure to thrive, however, which is common in such infants, may well be associated with congenital cardiac anomalies and should be carefully ruled out. Treatment of cardiac fibromas is discussed along with the usefulness of two-dimensional echocardiography and the importance of the team approach in the management of these infants.
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