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Primary pediatric cardiac tumors: a 17 year experience

Published online by Cambridge University Press:  19 August 2008

Denver Sallee ,
Michael L. Spector ,
Daniel W. van Heeckeren  and
Chandrakant R. Patel
Denver Sallee
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, and the Department of Cardiothoracic Surgery, Rainbow Babies and Childrens Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA
Michael L. Spector
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, and the Department of Cardiothoracic Surgery, Rainbow Babies and Childrens Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA
Daniel W. van Heeckeren
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, and the Department of Cardiothoracic Surgery, Rainbow Babies and Childrens Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA
Chandrakant R. Patel*
Affiliation:
Department of Pediatrics, Division of Pediatric Cardiology, and the Department of Cardiothoracic Surgery, Rainbow Babies and Childrens Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA
*
Chandrakant R. Patel, M.B.,B.S., Rainbow Babies and Childrens Hospital Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106, USA. Tel: (216) 844-3275; Fax: (216) 844-5478
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Abstract

We reviewed 22 cases of primary pediatric cardiac tumors followed at our institution from January 1981 through November 1997, analyzing them by subtype, age and manner of presentation, location, associated findings, interventions, and clinical course. Rhabdomyomas were the most common (11), followed by intrapericardial teratomas (2), myxomas (1), fibromas (1), hemangiomas (1), mesotheliomas (1), and rhabdomyosarcomas (1), with 4 undetermined tumors. The majority (77%) of tumors were diagnosed before the age of one year, including six prenatally. The most common presentations were murmurs (5), arrhythmias (5), and abnormal screening fetal ultrasound examinations (4). Tumors were located most frequently in the right ventricle (13) and left ventricle (7), with multiple tumors being present in 10 cases. Eight patients (36%) had associated arrhythmias or conduction abnormalities, and of the 11 patients with rhabdomyomas, tuberous sclerosis was diagnosed in 8. Eight patients underwent cardiac catheterization, including two for electrophysiologic study with radiofrequency ablation, and seven patients had complete or partial tumor resection. The follow-up period ranged from 2 months to 15 years, and there were 3 tumor-related deaths. Therefore, despite the benign histology of most primary pediatric cardiac tumors, there may be significant associated morbidity and occasional mortality. As echocardiographic techniques such as fetal ultrasonography have continued to improve, however, these cardiac tumors have increasingly been detected early before significant symptoms develop.

Keywords

cardiac tumorschildhoodtuberous sclerosis
Type
Original Articles
Information
Cardiology in the Young , Volume 9 , Issue 2 , March 1999 , pp. 155 - 162
Copyright
Copyright © Cambridge University Press 1999

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References

Refrences

1.McAllister, HA Jr, Fenoglio, JJ Jr. Tumors of the cardiovascular system. In: Subcommittee on Oncology of the National Research Council's Committee on Pathology, ed. Atlas of tumor pathology. Fascicle 15, series 2. Washington, DC: Armed Forces Institute of Pathology, 1978.Google Scholar
2.McAllister, HA Jr. Primary tumors of the heart and pericardium. Path Annu 1979; 14: 325–355.Google ScholarPubMed
3.Nadas, AS, Ellison, RC. Cardiac tumors in infancy. Am J Cardiol 1968; 21: 363–366.CrossRefGoogle ScholarPubMed
4.Marx, GR. Cardiac tumors. In: Emmanouilides, GC, Riemenschneider, TA, Allen, HD, Gutgesell, HP (eds). Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult, vol II, Fifth Edition. Williams & Wilkins, Baltimore, 1995; 1773–1786.Google Scholar
5.Holley, DG, Martin, GR, Brenner, JI, Fyfe, DA, Huhta, JC, Kleinman, CS, Ritter, SB, Silverman, NH. Diagnosis and management of fetal cardiac tumors: a mukicenter experience and review of published reports. J Am Coll Cardiol 1995; 26: 516–520.CrossRefGoogle ScholarPubMed
6.Smythe, JF, Dyck, JD, Smallhorn, JF, Freedom, RM. Natural history of cardiac rhabdomyoma in infancy and childhood. Am J Cardiol 1990; 66: 1247–1249.Google Scholar
7.Farooki, ZQ, Ross, RD, Paridon, SM, Humes, RA, Karpawich, PP, Pinsky, WW. Spontaneous regression of cardiac rhabdomyoma. Am J Cardiol 1991; 67: 897–899.Google Scholar
8.Nir, A, Tajik, AJ, Freeman, WK, Seward, JB, Offord, KP, Edwards, WD, Mair, DD, Gomez, MR. Tuberous sclerosis and cardiac rhabdomyoma. Am J Cardiol 1995; 76, 419–421CrossRefGoogle ScholarPubMed
9.Webb, DW, Thomas, RD, Osborne, JP. Cardiac rhabdomyomas and their association with tuberous sclerosis. Arch Dis Child 1993; 68: 36–370.CrossRefGoogle ScholarPubMed
10.Choi, JY, Bae, EJ, Noh, CI, Yoon, YS, Hwang, YS. Cardiac rhabdomyoma in childhood tuberous sclerosis. Cardiol Young 1995; 5: 166–171.Google Scholar
11.Wilding, G, Green, HL, Longo, DL, Urba, WJ. Tumors of the heart and pericardium. Cancer Treat Rev 1988; 15: 165–181.Google Scholar
12.Chan, HSL, Sonley, MJ, Moes, CAF, Daneman, A, Smith, CR, Martin, DJ. Primary and secondary tumors of childhood involving the heart, pericardium, and great vessels: a report of 75 cases and review of the literature. Cancer 1985; 56: 825–836.Google Scholar
13.Brizard, C, Latremouille, C, Jebaram, VA, Acar, C, Fabiani, JN, Delouche, A, Carpentier, AF. Cardiac hemangiomas. Ann Thorac Surg 1993; 56: 390–394.Google Scholar
14.Jacobs, JP, Konstantakos, AK, Holland, FW, Herskowitz, K, Ferrer, PL, Perryman, RA. Surgical treatment for cardiac rhabdomyomas in children. Ann Thorac Surg 1994; 58: 1552–1555.CrossRefGoogle ScholarPubMed
15.Hwa, J, Ward, C, Nunn, G, Cooper, S, Lau, K-C, Sholler, G. Primary interventricular cardiac tumors in children: contemporary diagnostic and management options. Pediatr Cardiol 1994; 15: 233–237.Google Scholar
16.Takach, TJ, Reul, GJ, Ott, DA, Cooley, DA. Primary cardiac tumors in infants and children: immediate and long-term operative results. Ann Thorac Surg 1996; 62: 559–564.Google Scholar
17.Marin, Garcia J, Fitch, CW, Shenefelt, RE. Primary right ventricular tumor (fibroma) simulating cyanotic heart disease in a newborn. J Am Coll Cardiol 1984; 3: 868–871.CrossRefGoogle Scholar
18.Filiatrault, M, Beland, MJ, Neilson, KA, Paquet, M. Cardiac fibroma presenting with clinically significant arrhythmias in infancy. Pediatr Cardiol 1991; 12: 118–120.Google Scholar
19.Watanabe, T, Hojo, Y, Kozaki, T, Nagashima, M. Hypoplastic left heart syndrome with rhabdomyoma of the left ventricle. Pediatr Cardiol 1991; 12: 121–122.Google Scholar
20.Thorgeirsson, G, Liebman, J. Mesothelioma of the AV node. Pediatr Cardiol 1983; 4: 219–224.Google Scholar
21.Small, EJ, Gordon, GJ, Dahms, BB. Malignant rhabdoid tumor of the heart in an infant. Cancer 1985; 55: 2850–2853.Google Scholar
22.Butto, F. Massive cardiac tumor presenting as severe cyanosis in a newborn. Pediatr Cardiol 1994; 15: 103–105.Google Scholar
23.Van Hare, GF, Phoon, CK, Munkenbeck, R, Patel, CR, Fink, DL, Silverman, NH. Electrophysiologic study and radiofrequency ablation in patients with intracardiac tumors and accessory pathways: Is the tumor the pathway? J Cardiovasc Electrophysiol 1996; 7: 1204–1210Google Scholar
24.Fenoglio, JJ, McAllister, HA, Ferrans, VJ. Cardiac rhabdomyoma: a clinicopathologic and electron microscopic study. Am J Cardiol 1976; 38: 241–251.Google Scholar
25.Bass, JL, Breningstall, GN, Swaiman, KF. Echocardiographic incidence of cardiac rhabdomyoma in tuberous sclerosis. Am J Cardiol 1985; 55: 1379–1382.CrossRefGoogle ScholarPubMed
26.Harding, CO, Pagon, RA. Incidence of tuberous sclerosis in patients with cardiac rhabdomyoma. Am J Med Genet 1990; 37: 443–446.Google Scholar
27.Povey, S, Burley, MW, Attwood, J, Benham, F, Hunt, D, Jeremiah, SJ, Franklin, D, Gillett, G, Malas, S, Robson, EB. Two loci for tuberous sclerosis:, one on 9q34 and one on 16p13. Ann Hum Genet 1994; 58: 107–127.Google Scholar
28.Roach, ES, Smith, M, Huttenlocher, P, Bhat, M, Alcorn, D, Hawley, L. Diagnostic criteria: tuberous sclerosis complex., Report of the Diagnostic Criteria Committee of the National Tuberous Sclerosis Association. J Child Neurol 1992; 7: 221–224.Google Scholar
29.Sheu, B-C, Shyu, M-K, Lin, Y-F, Lee, C-N, Hsieh, F-J, Chou, Y-H, Yau, K-I, Huang, S-F. Prenatal diagnosis and corticosteroid treatment of diffuse neonatal hemangiomatosis: case report. J Ultrasound Med 1994; 13: 495–99.CrossRefGoogle ScholarPubMed
30.Benatar, A, Vaughan, J, Nicolini, U, Trotter, S, Corrin, B, Lincoln, C. Prenatal pericardiocentesis: its role in the management of intrapericardial teratoma. Obstet Gynecol 1992; 79,856–859Google Scholar
31.Todros, T, Gagliotti, P, Presbitero, P, Management of a fetus with intrapericardial teratoma diagnosed in utero. J Ultrasound Med 1991; 10: 287–290.Google Scholar
32.Catanzarite, V, Mehalek, K, Maida, C, Mendoza, A. Early sonographic diagnosis of intrapericardial teratoma. Ultrasound Obstet Gynecol 1994; 4: 505–507.Google Scholar
33.Russell, GA, Dhasmana, JP, Berry, PJ, Gilbert-Barnes, . Coexistent cardiac tumours and malformations of the heart. Int J Cardiol 1989; 22: 89–98.CrossRefGoogle ScholarPubMed
34.Davis, AM, Silver, MM, Freedom, RM. Benign congenital cardiac tumor associated with a ‘malignant’ cardiac malformation. Cardiol Young 1996; 6: 84–87.Google Scholar
35.Mehta, AV. Rhabdomyoma and ventricular pre-excitation syndrome: a report of two cases and review of the literature. Am J Dis Child 1993; 147: 669–671.Google Scholar