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Calcified right ventricular fibroma causing outflow obstruction. Report of a case with successful excision

Insights

A rare calcified right ventricular fibroma caused pulmonic stenosis in a child. Surgical removal successfully treated the obstruction, with significant hemodynamic improvement post-operation.

Area of Science:

  • Cardiology
  • Pediatric Oncology
  • Cardiac Surgery

Background:

  • Fibromas are rare benign tumors that can occur in the heart.
  • Right ventricular fibromas can cause significant outflow tract obstruction and hemodynamic compromise.
  • Calcification within cardiac tumors is uncommon, particularly in pediatric fibromas.

Observation:

  • A 5-year-old boy presented with symptoms of pulmonic stenosis.
  • Imaging revealed a large calcified mass in the right ventricular outflow tract, causing a 120 mm Hg gradient.
  • Surgical exploration identified an oval-shaped tumor obstructing the right ventricular outflow tract, attached to the interventricular septum.

Findings:

  • The obstructing tumor was surgically removed.
  • Histological examination confirmed the mass as a fibroma.
  • Post-operative hemodynamic studies showed near-complete resolution of the pressure gradient.

Implications:

  • This case represents the fifth reported instance of a calcified right ventricular fibroma with successful surgical intervention.
  • Intracardiac calcifications causing obstruction in children strongly suggest the possibility of a fibroma.
  • Early diagnosis and surgical management are crucial for favorable outcomes in pediatric cardiac tumors causing obstruction.

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