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Pediatric primary benign cardiac tumors: a 15-year review
1Division of Cardiology, The Hospital for Sick Children and the Faculty of Medicine, University of Toronto, Ontario, Canada.
Insights
Pediatric primary cardiac tumors, especially rhabdomyomas, are increasingly diagnosed with advanced imaging. Most cases show excellent prognosis, with surgery effectively treating symptomatic tumors.
Area of Science:
- Pediatric Cardiology
- Oncology
Background:
- Noninvasive imaging advancements have increased primary cardiac tumor detection in children.
- Rhabdomyomas are the most common type, followed by fibromas.
Purpose of the Study:
- To analyze the incidence, types, diagnosis, and outcomes of primary cardiac tumors in pediatric patients.
- To evaluate the role of diagnostic modalities and surgical interventions.
Main Methods:
- Retrospective review of 56 pediatric patients diagnosed with primary cardiac tumors.
- Analysis of diagnostic methods including echocardiography, MRI, and catheterization.
- Assessment of treatment outcomes and prognosis.
Main Results:
- Incidence of cardiac tumors increased from 0.06% to 0.32% between 1980 and 1995.
- Rhabdomyomas constituted 78% of cases; diagnosis was primarily via echocardiography.
- No tumor-related deaths occurred; 54% of rhabdomyomas showed regression, and surgery was safe for symptomatic cases.
Conclusions:
- Primary cardiac tumors in children have an excellent prognosis.
- Early diagnosis and individualized surgical treatment are effective for managing symptomatic tumors.
Abstract:
An increase in the incidence of primary cardiac tumors has been reported since the development or enhancement of noninvasive imaging modalities. We identified 56 children with primary cardiac tumors. Forty-four (78%) children had rhabdomyomas, 6 (11%) fibromas, 1 (2%) pericardial teratoma, 1 (2%) epicardial lipoma, 1 (2%) multicystic hamartoma, and 3 (5%) unspecified tumors. The mean age at diagnosis was 19 +/- 35 months (median 4.7 months, range 0.03 to 204 months), excluding 12 patients who were given the diagnosis before birth. Among 27,640 patients assessed for cardiac disease, the incidence of tumors was 0.06% (1980 to 1984), 0.22% (1985 to 1989), and 0.32% (1990 to 1995). Diagnosis was made in 55 of 56 patients by echocardiography. Catheterization was performed in five patients and magnetic resonance imaging in nine. No tumor-related deaths occurred. Nine patients had surgery because of hemodynamically significant obstruction or arrhythmias. Partial or complete regression occurred in 24 (54%) of 44 patients with rhabdomyomas. Overall, the prognosis was excellent. Individualized surgery allowed early safe treatment of symptomatic tumors.