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Published on: February 6, 2019
Cardiac tumours in children: a single-centre experience and literature review
Diogo Faim1, Andreia Francisco1, António Pires1
1Department of Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Insights
Pediatric cardiac tumors are rare but can cause serious symptoms. While most are benign, imaging like cardiac MRI aids diagnosis, and surgery is recommended for symptomatic cases.
Area of Science:
- Pediatric Cardiology
- Pediatric Oncology
- Cardiovascular Imaging
Background:
- Cardiac tumors in children are exceptionally rare, with over 90% being benign.
- Despite being benign, these tumors can lead to severe complications such as obstruction, embolization, arrhythmias, cardiac tamponade, and sudden death.
- While many pediatric cardiac tumors are asymptomatic and may regress spontaneously, long-term follow-up is crucial due to the potential for late-onset symptoms.
Purpose of the Study:
- To provide a comprehensive overview of the current understanding of cardiac tumors in the pediatric population.
- To highlight the diagnostic capabilities of cardiac magnetic resonance imaging in inferring tumor type.
- To discuss the indications for surgical intervention in pediatric cardiac tumors.
Main Methods:
- Review of current literature on pediatric cardiac tumors.
- Analysis of imaging features, particularly cardiac magnetic resonance (CMR), for tumor characterization.
- Discussion of clinical presentation, diagnostic approaches, and management strategies, including surgical resection.
Main Results:
- Cardiac tumors in children, though rare, necessitate careful management due to potential life-threatening complications.
- Cardiac magnetic resonance imaging offers high accuracy in predicting tumor histology.
- Surgical resection is the recommended treatment for symptomatic tumors, those causing obstruction, cardiac dysfunction, or presenting a high risk of embolization.
Conclusions:
- Accurate diagnosis and timely management are critical for pediatric patients with cardiac tumors.
- Cardiac MRI is an invaluable tool for non-invasive diagnosis and characterization of these rare tumors.
- A tailored approach to follow-up and treatment, including surgical intervention when indicated, is essential for optimizing outcomes.
Abstract:
Cardiac tumours are extremely rare in children. Although more than 90% are benign, children can develop obstructive or embolisation derived symptoms, arrhythmias, constitutional symptoms, cardiac tamponade, or even sudden death. Although the majority are asymptomatic, and some spontaneously regress, appropriate follow-up is needed on a case-by-case basis, as patients may develop late symptoms. Definitive diagnosis is only possible through histological analysis; however, it is possible to infer tumour type with a high grade of certainty based on imaging features, particularly cardiac magnetic resonance. Surgical resection is advocated for those causing symptoms, obstruction, cardiac dysfunction, and high risk of embolisation. The aim of this review is to present the state of the art related to cardiac tumours in the paediatric population, in the context of our own experience.
