Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 2, March-April, p. 319–326
Publication type: original article
Cardiac tumors in children: A 20-year review of clinical presentation, diagnostics and treatment
1 Department of Pediatric Cardiology and Congenital Heart Defects, Medical University of Gdańsk, Poland
2 Department of Clinical Anatomy, Medical University of Gdańsk, Poland
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.
Conclusion. 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.
tumor, cardiac, pediatric, fetal
- Becker AE. Primary heart tumors in the pediatric age group: A review of salient pathologic features relevant for clinicians. Pediatr Cardi-ol. 2000;21:317–323.
- Beghetti M, Gow RM, Haney I, Mawson J, Williams WG, Freedom RM. Pediatric primary benign cardiac tumors: A 15-year review. Am Heart J. 1997;134:1107–1114.
- Hoey ETD, Shahid M, Ganeshan A, Baijal S, Simpson H, Watkin RW. MRI assessment of cardiac tumours: Part 1, multiparametric imaging proto-cols and spectrum of appearances of histologiacally benign lesions. Quant Imaging Med Surg. 2014;4:478–488.
- Reynen K. Frequency of primary tumors of the heart. Am J Cardiol. 1996;77:107–116.
- Uzun O, Wilson DG, Vujanic GM, Parsons JM, De Giovanni JV. Cardiac tumours in children. Orphanet J Rare Dis. 2007;2:11–25.
- Gunter T, Schreiber Ch, Noebaur Ch, Eicken A, Lange R. Treatment strategies for pediatric patients with primary cardiac and pericardial tumors: A 30-year review. Pediatr Cardiol. 2008;29:1071–1076.
- Marx GR, Moran AM. Cardiac tumors. In: Allen HD, Driscoll DJ, Shaddy RE, Feltes TF, eds. Heart Disease in infants, children and adolescents including the fetus and young adults. 8th ed. Moss and Adams’, Lippincott Williams & Wilkins;2013:1549–1564.
- Simcha A, Wells BG, Tynan MJ, Waterston DJ. Primary cardiac tumours in childhood. Arch Dis Child. 1971;46:508–514.
- Gusman M, Servaes S, Feygin T, Degenhardt K, Epelman M. Multimodal imaging in the prenatal diagnosis of tuberous sclerosis complex. Case Rep Pediatr. 2012;925–646.
- Burke A, Virmani R. Pediatric heart tumors. Cardiovascular Pathology. 2008;17:193–198.
- Freedom RM, Lee KJ, MacDonald C, Taylor G. Selected aspects of cardiac tumors in infancy and childhood. Pediatr Cardiol. 2000;21: 299–316.
- Isaacs H. Fetal and neonatal cardiac tumors. Pediatr Cardiol. 2004; 25:252–273.
- Kwiatkowska J, Aleszewicz-Baranowska J, Komorowska W, Siebert J. Rodzinne występowanie choroby Bourneville’a-Pringle’a: opis przy-padku. Fam Med Prim Care Rev. 2008;10:1212–1214.
- Perdeus P, Werner B, Kaliciński Z. Cardiac tamponade in a neonate with cardiac tumour. Kardiol Pol. 2006;64:309–311.
- Thomas-de-Montprevillea V, Nottinb R, Dulmeta E, Serrafc A. Heart tumors in children and adults: clinicopathological study of 59 patients from a surgical center. Cardiovascular Pathology. 2007; 16:22– 28.
- Moradian M, Dalili M, Merajie M. Prenatal diagnosis of tuberous sclerosis by fetal echocardiography with an unusual clinical course after birth. Arch Cardiovasc Image. 2013;1:83–85.
- Sallee D, Spector ML, van Heeckeren DW, Patel CR. Primary pediatric cardiac tumors: A 17-year experience. Cardiol Young. 1999;9:155–162.
- Aleszewicz-Baranowska J, Potaż P, Kwiatkowska J, Ereciński J, Komorowska-Szczepańska W. Komorowe zaburzenia rytmu u młodego spor-towca z guzem serca: koincydencja czy przyczyna? Fam Med Prim Care Rev. 2009;11:812–814.
- Bang K, Kim YH, Kim CS, Lee SL, Kwon TC. Supraventricular tachycardia in neonate with cardiac rhabdomyoma and tuberous sclerosis. Korean J Pediatr. 2008; 51:766–770.
- Bosi G, Lintermans JP, Pellegrino PA, Svaluto-Moreolo G, Vliers A. The natural history of cardiac rhabdomyoma with and without tuberous sclerosis. Acta Paediatr. 1996;85:928–931.
- Holley DG, Martin GR, Brenner JI, et al. Diagnosis and management of fetal cardiac tumors: A multicenter experience and review of pub-lished reports. J Am Coll Cardiol. 1995;26:516–20.
- Verhaaren HA, Vanakker O, De Wolf D, Suys B, Francois K, Matthys D. Left ventricular outflow obstruction in rhabdomyoma of infancy: Me-ta-analysis of the literature. J Pediatr. 2003;143:258–263.
- Kaminaga T, Takeshita T, Kimura I. Role of magnetic resonance imaging for evaluation of tumors in the cardiac region. Eur Radiol. 2003;13:L1–L10.
- Beroukhim RS, Prakash A, Buechel ERV, et al. Characterization of cardiac tumors in children by cardiovascular magnetic resonanse imaging. JACC. 2011;10:1044–1054.
- Sparrow PJ, Kurian JB, Jones TR, Sivananthan MU. MR Imaging of Cardiac Tumors. Radio Graphics. 2005;25:1255–1276.
- Kiaffas MG, Powell AJ, Geva T. Magnetic resonance imaging evaluation of cardiac tumor characteristics in infants and children. Am J Cardiol. 2002; 89: 1229–1233.
- Coard KCM. Primary tumors of the heart: Experience at the University Hospital of the West Indies. Cardiovascular Pathology. 2007;16: 98–103.
- Yu K, Liu Y, Wang H, Hu S, Long C. Epidemiological and pathological characteristics of cardiac tumors: A clinical study of 242 cases. Interact Cardio Vasc Thorac Surg. 2007;6:636–639.
- ElBardissi AV, Dearani JA, Daly RC, et al. Survival after resection of primary cardiac tumors. A 48-year experience. Circulation. 2008; 118(Suppl 1):S7–S15.
- Kamiya H, Yasuda T, Nagamine H, et al. Surgical treatment of primary cardiac tumors 28 years’ experience in Kanazawa University Hospital. Jpn Circ J. 2001;65:315–319.