Primary Cardiac Tumors in Infancy: A Case Report and Literature Review

Abstract

Sudden death in infants due to primary cardiac tumors is extremely rare. Herein we describe a case of an 8-month-old male infant, without any previous medical history, who died in a hospital in the city of Medellín-Antioquia, Colombia. The family stated that approximately 15 minutes after he received a bottle, the baby became cyanotic and subsequently lost consciousness. He was taken to the hospital immediately; however, he arrived lifeless. As this was a sudden death case, the child was referred to the Institute of Legal Medicine and Forensic Sciences in the city of Medellín to clarify the cause, manner, and mechanism of death. The forensic autopsy revealed a eutrophic infant with central and peripheral cyanosis, without signs of trauma, and the internal examination found a single cardiac tumor in the anterior wall of the left ventricle. The mass was white and whorled; histological evaluation diagnosed a fibroma. The manner of death was natural due to a cardiogenic shock caused by a primary tumor.

Cardiac tumours in children: a single-centre experience and literature review

“…5 Despite its benignity, they tend to cause obstruction 28 to blood flow and sudden death can be a form of presentation. 29 Several patients have accidental diagnoses but even these can present with symptoms later in life or electrocardiographic abnormalities. [30][31][32] A large heterogeneous solid mass observed echocardiographically (Fig 3) strongly suggests this tumour type, but the most pathognomonic sign is the existence of central calcification on CT. 7 The calcification occurs because of lack of blood supply to the mass, hence related to ischaemic changes.…”

“…Areas of calcification, necrosis, and cystic degeneration are common. 13,29 Fibromas do not spontaneously regress and, as a group, represent the most resected cardiac tumour type in children. 5 Total or partial resection is advocated in symptomatic patients and in asymptomatic with giant masses.…”

Incidental finding of a right ventricular mass: Fibroma or thrombosis?

“…One of the primary benign tumors is a mesenchymal tumor, cardiac fibroma consists of collagen fibers and fibroblasts collectively causing fibrosis. This benign tumor is very rare in adults but common in fetuses or infants with a prevalence of 5%-25% of all primary cardiac tumors [7] . Presenting symptoms include chest pain, fatigue, dyspnea, faint, arrythmias, dysfunction in conduction, or sudden death.…”

Cardiac Myosarcoma in a Newborn Infant—A Case Report and Literature Review

“…In the latter, cardiac myxomas are the most common tumors ( 8 , 14 ). In infants, the most common primary tumor of the heart is the rhabdomyoma (44–78%), followed by fibroma, teratoma, vascular tumors, and myxoma ( 10 , 15 – 17 ). So, any intracavitary mass in infants is suggestive of a cardiac rhabdomyoma unless proven otherwise ( 14 , 18 ).…”

“…So, any intracavitary mass in infants is suggestive of a cardiac rhabdomyoma unless proven otherwise ( 14 , 18 ). There is a high incidence of associated tuberous sclerosis among infants with rhabdomyoma, ~50–86%, that's why all neonates and fetuses with suspected rhabdomyoma need further genetic examination for Tuberous Sclerosis ( 13 , 17 , 19 , 20 ).…”