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Primary cardiac tumours in infancy and childhood. A review and six case reports
Insights
Primary cardiac tumors are rare in children. Diagnosis is challenging, often requiring autopsy, but echocardiography and angiocardiography aid detection. Surgical outcomes depend on tumor type, size, and multifocality.
Area of Science:
- Pediatric Cardiology
- Pediatric Oncology
- Cardiac Surgery
Background:
- Primary cardiac tumors are exceptionally rare in pediatric populations.
- Early diagnosis and treatment are critical for improving patient outcomes.
Observation:
- A study reviewed 6 pediatric patients (17 days to 10 years) with primary cardiac tumors.
- Tumor types included fibroma, myxoma, hemangioma, and rhabdomyoma.
- Pre-operative diagnosis was missed in 3 cases, with diagnosis confirmed at autopsy.
Findings:
- Three patients underwent cardiac surgery, with one unsuccessful outcome.
- Surgical challenges included tumor infiltration and multifocal disease.
- Echocardiography and angiocardiography are essential diagnostic tools.
- Large tumors or conduction tissue involvement indicate a poor prognosis.
Implications:
- Multifocal cardiac tumors can be surgically removed, even in neonates.
- Prognosis is influenced by tumor characteristics and associated conditions like tuberous sclerosis in rhabdomyomas.
- Accurate pre-operative diagnosis is crucial for effective management of pediatric cardiac tumors.
Abstract:
Primary cardiac tumours are rarities in infants and children. We have had 6 patients, aged 17 days to 10 years, with primary cardiac tumours: 1 had a fibroma, 1 had a myxoma, 2 had an haemangioma and 2 had a rhabdomyoma. Correct diagnosis was missed pre-operatively in 3 cases and finally established at autopsy. Three of the patients underwent cardiac operation-one of them unsuccessfully. At surgery the main difficulties were with tumour infiltration and the multifocal nature of some tumours. We conclude that the echo- and angiocardiography are essential tools in the diagnosis of primary cardiac tumours. Large tumours or conduction tissue infiltration means an extremely poor prognosis. Multifocal cardiac tumours can be successfully removed, even in newborn babies, and the outcome for the patients is also affected by other important factors, e.g. tuberous sclerosis in rhabdomyomas.
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