Cardiac tumors in children: A 20-year review of clinical presentation, diagnostics and treatment

Abstract

Background. The use of new imaging techniques has contributed significantly to earlier diagnosis and treatment of cardiac tumors.Objectives. The aim of the study was to analyze data from children with cardiac tumors in terms of clinical presentation, the role of noninvasive diagnostic procedures and the long-term outcome.Material and methods. The data analyzed retrospectively concerned 30 children in whom cardiac tumors were diagnosed from January 1995 to July 2015. The cardiac evaluation included a review of the subjects' medical records and medical history, a physical examination, standard 12-lead electrocardiography, echocardiography and 24-h Holter ECG monitoring at the time of diagnosis and at 6-12 month intervals during the follow-up at the authors' outpatient clinic.Results. Most of the children did not need cardiac surgery; surgical tumor excision was necessary in 3 cases only. There was 1 death in the follow-up period. Rhabdomyoma was diagnosed in 22 cases, and in 16 of them tuberous sclerosis was confirmed during the follow-up period. In the remaining 8 cases, fibroma was the most likely diagnosis.Conclusions. The symptomatology of cardiac tumors in children can vary greatly, from the absence of any symptoms up to heart failure and respiratory distress indicating the need for surgical intervention. The diagnosis of cardiac tumors relies almost exclusively on noninvasive imaging techniques. The observations in this study confirm the fact that the most common cardiac tumor in children is rhabdomyoma, which may disappear spontaneously. Most patients with cardiac tumors do not require treatment.

Giant Right Atrial Myxoma with Fulminant Progression in an Infant

“…A study by Kwiatkowska et al reported the most commonly observed cardiac tumor in children was rhabdomyoma. 12 Also, this study reported that most cardiac tumors do not require treatment and undergo spontaneous regression. 12 The causes of sudden death due to cardiac tumors are arrhythmia, emboli and heart failure due to compression of the cardiac chambers or outflow (inflow) tract obstruction.…”

Echocardiography and Newer Imaging Techniques in Diagnosis and Long-Term Follow-Up of Primary Heart Tumors in Children

“…The other symptoms observed in heart tumors are murmur, tachypnea, cyanosis, manifestations of heart failure, and various types of arrhythmia [ 13 , 14 , 15 ]. Older patients reported a reduction in the tolerance for physical activity, as well as arrhythmia, dyspnea, fainting, and chest pain.…”

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“…Con menos frecuencia pueden encontrarse en el ultrasonido tuberosidades corticales (tubers), que se delinean mejor mediante resonancia magnética fetal, que conviene solicitarla luego de detectar uno o más rabdomiomas fetales. [4][5][6][7][8][9][10] En el ultrasonido, los rabdomiomas aparecen como masas con ecogenicidad aumentada y homogénea, ubicadas con mayor frecuencia dentro de los ventrículos, sobre el septum interventricular y, excepcionalmente, en las aurículas. Se encuentran, sobre todo, entre las 20 y 30 semanas de gestación y pueden aumentar de tamaño y número.…”

“…Aun así, todos estos tumores requieren vigilancia estrecha, sobre todo los de localización o dimensiones que pueden alterar la hemodinamia, producir disritmias o insuficiencia cardiaca durante el periodo fetal y posnatal temprano (estos son los únicos casos susceptibles de intervención quirúrgica). [9][10][11][12][13] El objetivo de este trabajo es reportar la primera serie de casos de detección prenatal de rabdomiomas. 14,15,16…”