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

Published online by Cambridge University Press:  28 February 2022

Diogo Faim*
Affiliation:
Department of Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Andreia Francisco
Affiliation:
Department of Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
António Pires
Affiliation:
Department of Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
*
Author for correspondence: D. Faim, Department of Paediatric Cardiology, Centro Hospitalar e Universitário de Coimbra, Avenida Dr. Afonso Romão, Coimbra 3000-602, Portugal. Tel: +351967768038; Fax: 239 717 216. E-mail: diogofaim92@gmail.com

Abstract

Cardiac tumours are extremely rare in children. Although more than 90% are benign, children can develop obstructive or embolisation derived symptoms, arrhythmias, constitutional symptoms, cardiac tamponade, or even sudden death. Although the majority are asymptomatic, and some spontaneously regress, appropriate follow-up is needed on a case-by-case basis, as patients may develop late symptoms. Definitive diagnosis is only possible through histological analysis; however, it is possible to infer tumour type with a high grade of certainty based on imaging features, particularly cardiac magnetic resonance. Surgical resection is advocated for those causing symptoms, obstruction, cardiac dysfunction, and high risk of embolisation. The aim of this review is to present the state of the art related to cardiac tumours in the paediatric population, in the context of our own experience.

Type
Review
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Tzani, A, Doulamis, IP, Mylonas, KS, Avgerinos, DV, Nasioudis, D. Cardiac tumors in pediatric patients: a systematic review. World J Pediatr Congenit Heart Surg 2017; 8: 624632.CrossRefGoogle ScholarPubMed
Carrilho, MC, Tonni, G, Araujo, E. Tumores cardíacos fetais: diagnóstico pré-natal e resultados. Brazilian J Cardiovasc Surg 2015; 30: 67.Google Scholar
Yadava, OP. Cardiac tumours in infancy. Indian Heart J 2012; 64: 492496.CrossRefGoogle ScholarPubMed
Sánchez Andrés, A, Insa Albert, B, Carrasco Moreno, JI, Cano Sánchez, A, Moya Bonora, A, Sáez Palacios, JM. Tumores cardíacos primarios en la infancia. An Pediatr 2008; 69: 1522.CrossRefGoogle Scholar
Castillo, JG, Silvay, G. Characterization and management of cardiac tumors. Semin Cardiothorac Vasc Anesth 2010; 14: 620.CrossRefGoogle ScholarPubMed
Poterucha, TJ, Kochav, J, O’Connor, DS, Rosner, GF. Cardiac tumors: clinical presentation, diagnosis, and management. Curr Treat Options Oncol 2019; 20: 115.10.1007/s11864-019-0662-1CrossRefGoogle ScholarPubMed
Uzun, O, Wilson, DG, Vujanic, GM, Parsons, JM, De Giovanni, JV. Cardiac tumours in children. Orphanet J Rare Dis 2007; 2: 114.CrossRefGoogle ScholarPubMed
Günther, T, Schreiber, C, Noebauer, C, Eicken, A, Lange, R. Treatment strategies for pediatric patients with primary cardiac and pericardial tumors: a 30-year review. Pediatr Cardiol 2008; 29: 10711076.CrossRefGoogle ScholarPubMed
Kewcharoen, J, Prasongdee, K, Sinphurmsukskul, S, et al. Recurrent cardiac myxoma treated by orthotopic heart transplantation: a case report and literature review of heart transplantation for primary cardiac tumor. Case Rep Transplant 2018; 2018: 17.10.1155/2018/2456949CrossRefGoogle ScholarPubMed
Paramés, F, Freitas, I, Martins, JDF, et al. Tumores cardíacos. Experiência de 17 anos num serviço de cardiologia pediátrica. Rev Port Cardiol 2009; 28: 929940.Google Scholar
Mariano, A, Pita, A, León, R, et al. Primary cardiac tumors in children: a 16-year experience. Ver Port Cardiol 2009; 28: 279288.Google ScholarPubMed
Burke, A, Virmani, R. Pediatric heart tumors. Cardiovasc Pathol 2008; 17: 193198.CrossRefGoogle ScholarPubMed
Freedom, RM, Lee, K-J, MacDonald, C, Taylor, G. Selected aspects of cardiac tumors in infancy and childhood. Pediatr Cardiol 2000; 21: 299316.CrossRefGoogle ScholarPubMed
Scollon, S, Anglin, AK, Thomas, M, Turner, JT, Wolfe Schneider, K. A comprehensive review of pediatric tumors and associated cancer predisposition syndromes. J Genet Couns 2017; 26: 387434.CrossRefGoogle ScholarPubMed
Thomas-de-Montpréville, V, Nottin, Rémi, Dulmet, E, Serraf, A. Heart tumors in children and adults: clinicopathological study of 59 patients from a surgical center. Cardiovasc Pathol 2007; 16: 2228.CrossRefGoogle ScholarPubMed
Lefort, B, Lothion, J, Arid, JM, El, etal. Unusual outcome of a right ventricular rhabdomyoma in an infant. World J Pediatr Congenit Heart Surg 2016; 7: 397399.CrossRefGoogle ScholarPubMed
Mir, A, Ikemba, CM, Reddy, SRV. Hypoplastic left heart syndrome secondary to intrauterine rhabdomyoma necessitating single ventricle palliation. Ann Pediatr Cardiol 2014; 7: 207209.CrossRefGoogle ScholarPubMed
Sadoh, WE, Obaseki, DE, Amuabunos, EA, et al. Cardiac rhabdomyoma in a neonate with supraventricular tachycardia. World J Pediatr Congenit Hear Surg 2014; 5: 110113.10.1177/2150135113501899CrossRefGoogle Scholar
Wakai, RT, Strasburger, JF, Li, Z, Deal, BJ, Gotteiner, NL. Magnetocardiographic rhythm patterns at initiation and termination of fetal supraventricular tachycardia. Circulation 2003; 107: 307312.CrossRefGoogle ScholarPubMed
Wacker-Gussmann, A, Strasburger, JF, Cuneo, BF, Wiggins, DL, Gotteiner, NL, Wakai, RT. Fetal arrhythmias associated with cardiac rhabdomyomas. Hear Rhythm 2014; 11: 677683.CrossRefGoogle ScholarPubMed
Mendes, Iês C, Araújo, AR, Anjos, R, Teixeira, A. Fetal giant cardiac tumor. Rev Port Cardiol 2017; 36: 673674.CrossRefGoogle ScholarPubMed
Tao, TY, Yahyavi-Firouz-Abadi, N, Singh, GK, Bhalla, S. Pediatric cardiac tumors: clinical and imaging features. Radiographics 2014; 34: 10311046.10.1148/rg.344135163CrossRefGoogle ScholarPubMed
Martínez-García, A, Michel-Macías, C, Cordero-González, G, et al. Giant left ventricular rhabdomyoma treated successfully with everolimus: case report and review of literature. Cardiol Young 2018; 28: 903909.CrossRefGoogle ScholarPubMed
Shibata, Y, Maruyama, H, Hayashi, T, et al. Effect and complications of everolimus use for giant cardiac rhabdomyomas with neonatal tuberous sclerosis. AJP Rep 2019; 9: e213e217.Google ScholarPubMed
Lee, SJ, Song, ES, Cho, HJ, Choi, YY, Ma, JS, Cho, YK. Rapid regression of obstructive cardiac rhabdomyoma in a preterm neonate after sirolimus therapy. Biomed Hub 2017; 2: 16.CrossRefGoogle Scholar
Weiland, MD, Bonello, K, Hill, KD. Rapid regression of large cardiac rhabdomyomas in neonates after sirolimus therapy. Cardiol Young 2018; 28: 485489.10.1017/S104795111700244XCrossRefGoogle ScholarPubMed
Stelmaszewski, EV, Parente, DB, Farina, A, et al. Everolimus for cardiac rhabdomyomas in children with tuberous sclerosis. The ORACLE study protocol (everOlimus for caRdiac rhAbdomyomas in tuberous sCLErosis): a randomised, multicentre, placebo-controlled, double-blind phase II trial. Cardiol Young 2020; 30(3): 337–345.CrossRefGoogle ScholarPubMed
Marshall, AS, Dabal, RJ, Law, MA. A large ventricular fibroma requiring surgical resection in a symptomatic 3-month-old infant. Cardiol Young 2019; 30(1): 129–130.CrossRefGoogle Scholar
Dominguez, C, Perkins, A, Duque, A, Bravo, V. Primary cardiac tumors in infancy: a case report and literature review. Acad Forensic Pathol 2017; 7: 112118.CrossRefGoogle ScholarPubMed
Cordinhã, C, Pereira, Â., Silva, PV, et al. Tumor cardíaco em criança assintomática: um diagnóstico acidental. Rev Port Cardiol 2011; 30: 795797.CrossRefGoogle Scholar
Epifânio, P, Amaral, ME, Noronha, N, et al. Tumor cardíaco em lactente. Rev Port Cardiol 2018; 37: 9394.CrossRefGoogle Scholar
Varlamis, GS, Chalemis, Z, Haritandi, A, et al. Primary intramural fibroma of the left ventricle with a late apparent symptomatology. Hell J Cardiol 2005; 46: 362365.Google ScholarPubMed
Xu, Z, Wu, Q, Li, H, Zhang, M. Surgical resection of giant left ventricular fibromas in children. J Card Surg 2017; 32: 662664.CrossRefGoogle ScholarPubMed
Shi, L, Wu, L, Fang, H, et al. Identification and clinical course of 166 pediatric cardiac tumors. Eur J Pediatr 2017; 176: 253260.CrossRefGoogle ScholarPubMed
Pratt, JW, Cohen, DM, Mutabagani, KH, Davis, JT, Wheller, JJ. Neonatal intrapericardial teratomas: clinical and surgical considerations. Cardiol Young 2000; 10: 2731.CrossRefGoogle ScholarPubMed
Moura Garcia, A, Nery Dantas Junior, R, Kai Chi, C, Rodrigues Parga, J. Diagnóstico incidental tardio de teratoma intrapericárdico – relato de caso. Rev Port Cardiol 2017; 36: 571.e1571.e4.CrossRefGoogle Scholar
Kahlbau, H, Gomes, I, Pinto, F, Fragata, JIG. Uncommon multicystic lesion of the interventricular septum in a 7-year-old boy: unusual presentation of an intracardiac teratoma. Ann Thorac Surg 2016; 101: 23752377.CrossRefGoogle Scholar
Farooki, ZQ, Chang, CH, Jackson, WL, et al. Intracardiac teratoma in a newborn. Clin Cardiol 1988; 11: 642644.CrossRefGoogle Scholar
De Bellaing, AM, Houyel, L, Bonnet, D. Perinatal intracardiac teratoma: unusual presentation and review of the literature. Cardiol Young 2019; 29: 439441.CrossRefGoogle Scholar
Younes, M, Al-Dairy, A, Albadr, A. Right atrial myxoma detected in a child two months after open-heart surgery. Asian Cardiovasc Thorac Ann 2019; 27: 584586.CrossRefGoogle Scholar
Mani, A, Gopalakrishnan, A, Ayyappan, A, Valaparambil, A. Image of the month: ventricular myxoma mimicking hypertrophic cardiomyopathy. Clin Med 2019; 19: 131132.CrossRefGoogle ScholarPubMed
Kumagai, K, Sai, S, Endo, M, Tabayashi, K. Right ventricular myxoma obstructing the pulmonary artery during early childhood. Gen Thorac Cardiovasc Surg 2008; 56: 351353.CrossRefGoogle ScholarPubMed
Wu, Y, Fu, XM, Liao, XB, et al. Stroke and peripheral embolisms in a pediatric patient with giant atrial myxoma case report and review of current literature. Med (United States) 2018; 97: 2831.Google Scholar
Padalino, MA, Basso, C, Moreolo, GS, Thiene, G, Stellin, G. Left atrial myxoma in a child: case report and review of the literature. Cardiovasc Pathol 2003; 12: 233236.CrossRefGoogle Scholar
Macias, E, Nieman, E, Yomogida, K, et al. Rare presentation of an atrial myxoma in an adolescent patient: a case report and literature review. BMC Pediatr 2018; 18: 17.CrossRefGoogle Scholar
Guntheroth, WG, Fujioka, MC, Reichenbach, DD. Spontaneous resolution of obstructive valvular tumors in infants. Am Heart J 2002; 143: 868872.CrossRefGoogle ScholarPubMed
Elbardissi, AW, Dearani, JA, Daly, RC, et al. Survival after resection of primary cardiac tumors: a 48-year experience. Circulation 2018; 118(Suppl. 14): S7–15.Google Scholar
Onan, B, Haydin, S, Onan, IS, Akdeniz, C, Odemis, E, Bakir, I. Giant tumor of the right atrium in infancy. Ann Thorac Surg 2011; 92: 737740.CrossRefGoogle ScholarPubMed
Cohen, MI, Collazo, LR, Firan, A, Dangol, A, Atkins, MB. An unusual presentation of a large cardiac mass. Cardiol Young 2019; 29: 15491551.CrossRefGoogle ScholarPubMed
Zerbo, S, Argo, A, Maresi, E, Liotta, R, Procaccianti, P. Sudden death in adolescence caused by cardiac haemangioma. J Forensic Leg Med 2009; 16: 156158.CrossRefGoogle ScholarPubMed
Mackie, AS, Kozakewich, HPW, Geva, T, Perez-Atayde, AR, Mulliken, JB. Vascular tumors of the heart in infants and children: case series and review of the literature. Pediatr Cardiol 2005; 26: 344349.CrossRefGoogle ScholarPubMed
Heifetz, SA, Faught, PR, Bauman, M. Pathological case of the month. Arch Pediatr Adolesc Med 1995; 149: 56.CrossRefGoogle ScholarPubMed
Shehata, BM, Patterson, K, Thomas, JE, Scala-Barnett, D, Dasu, S, Robinson, HB. Histiocytoid cardiomyopathy: three new cases and a review of the literature. Pediatr Dev Pathol 1998; 1: 5669.CrossRefGoogle Scholar
Zangwill, SD, Trost, BA, Zlotocha, J, Tweddell, JS, Jaquiss, RD, Berger, S. Orthotopic heart transplantation in a child with histiocytoid cardiomyopathy. J Hear Lung Transplant 2004; 23: 902904.CrossRefGoogle Scholar
Eilers, AL, Nazarullah, AN, Shipper, ES, Jagirdar, JS, Calhoon, JH, Husain, SA. Cardiac inflammatory myofibroblastic tumor: a comprehensive review of the literature. World J Pediatr Congenit Hear Surg 2014; 5: 556564.CrossRefGoogle ScholarPubMed
Kheiwa, A, Turner, D, Schreiber, T. Left main coronary artery embolization in an 11-year-old girl due to inflammatory myofibroblastic tumor of the mitral valve. Catheter Cardiovasc Interv 2016; 87: 933938.CrossRefGoogle Scholar
Pang, Rée, Merritt, NH, Shkrum, MJ, Tijssen, JA. Febrile illness in an infant with an intracardiac inflammatory myofibroblastic tumor. Pediatrics 2016; 137: E174.CrossRefGoogle Scholar
Ferbend, P, Abramson, LP, Backer, CL, et al. Cardiac plasma cell granulomas: response to oral steroid treatment. Pediatr Cardiol 2004; 25: 406410.CrossRefGoogle ScholarPubMed
Andersen, ND, DiBernardo, LR, Linardic, CM, Camitta, MGW, Lodge, AJ. Recurrent inflammatory myofibroblastic tumor of the heart. Circulation 2012; 125: 23792381.CrossRefGoogle ScholarPubMed
Karimi, M, Vining, M, Pellenberg, R, Jajosky, R. Papillary fibroelastoma of tricuspid valve in a pediatric patient. Ann Thorac Surg 2013; 96: 10781080.CrossRefGoogle ScholarPubMed
Chadha, T, Cooke, S, Shillingford, M, Ceithaml, E. Rare etiology of acute embolic stroke in a 17-year-old girl: cardiac papillary fibroelastoma. J Pediatr Intensive Care 2018; 7: 5961.Google Scholar
Dénes, S, Daron, B, Behaeghe, M, et al. Cardiac papillary fibroelastoma of a bicuspid aortic valve in an adolescent: a case report. Clin Pract 2019; 9: 8183.CrossRefGoogle Scholar
Xu, B-J, Xie, X-Y, Tan, L-H, Shu, Q. Papillary fibroelastoma of the tricuspid valve in a 1-mo-old child. Indian J Pediatr 2013; 80: 353354.CrossRefGoogle Scholar
Wang, Y, Gong, F, Xie, C, Wang, W. A rare papillary fibroelastoma of the tricuspid valve in a 4-year-old girl. Pediatr Cardiol 2012; 33: 866868.CrossRefGoogle ScholarPubMed
Sun, JP, Asher, CR, Yang, XS, et al. Clinical and echocardiographic characteristics of papillary fibroelastomas: a retrospective and prospective study in 162 patients. Circulation 2001; 103: 26872693.CrossRefGoogle ScholarPubMed
Hoey, ETD, Shahid, M, Ganeshan, A, et al. MRI assessment of cardiac tumours: part 1, multiparametric imaging protocols and spectrum of appearances of histologically benign lesions. Quant Imaging Med Surg 2014; 4: 47847888.Google ScholarPubMed
Friedberg, MK, Chang, IL, Silverman, NH, Ramamoorthy, C, Chan, FP. Near sudden death from cardiac lipoma in an adolescent. Circulation 2006; 113: 778779.CrossRefGoogle Scholar
Husain, M, McCanta, A, Batra, AS. Rare finding of a pericardial lipoma in a pediatric patient presenting with ventricular tachycardia. Hear Case Reports 2019; 5: 277280.CrossRefGoogle Scholar
Padalino, MA, Reffo, E, Cerutti, A, et al. Medical and surgical management of primary cardiac tumours in infants and children. Cardiol Young 2008; 24: 268274.CrossRefGoogle Scholar
Itoh, K, Matsumura, T, Egawa, Y, et al. Primary mitral valve sarcoma in infancy. Pediatr Cardiol 1998; 19: 174177.CrossRefGoogle ScholarPubMed
Ludomirsky, A, Vargo, TA, Murphy, DJ, Gresik, MV, Ott, DA, Mullins, CE. Intracardiac undifferentiated sarcoma in infancy. J Am Coll Cardiol 1985; 6: 13621364.CrossRefGoogle ScholarPubMed
Gehrmann, J, Kehl, HG, Diallo, R, Volker, D, Johannes, V. Cardiac leiomyosarcoma of the right atrium in a teenager: unusual manifestation with a lifetime history of atrial ectopic tachycardia. Pacing Clin Electrophysiol 2001; 24: 11611164.CrossRefGoogle Scholar
Shanmugam, G. Primary cardiac sarcoma. Eur J Cardio-Thoracic Surg 2006; 29: 925932.CrossRefGoogle ScholarPubMed
Carras, S, Berger, F, Chalabreysse, L, et al. Primary cardiac lymphoma: diagnosis, treatment and outcome in a modern series. Hematol Oncol 2016; 35: 510519.CrossRefGoogle Scholar
Huh, J, Noh, CI, Kim, YW, et al. Secondary cardiac tumor in children. Pediatr Cardiol 1999; 20: 400403.CrossRefGoogle ScholarPubMed
Gross, GJ, Postovsky, S, Khoury, A. Rare haematogenous sarcoma metastasis to the heart in a child. Cardiol Young 2019; 29: 13051306.CrossRefGoogle Scholar
Murad, R, Bakkar, R, Sukkar, R, Mahmoud, F, Al-Dairy, A. A case of ewing sarcoma presenting with cardiac metastasis. World J Pediatr Congenit Hear Surg 2019; 10: 632634.CrossRefGoogle ScholarPubMed
Hartemayer, R, Kuo, C, Kent, P. Osteosarcoma metastases with direct cardiac invasion: a case report and review of the pediatric literature. J Pediatr Hematol Oncol 2017; 39: 188193.CrossRefGoogle ScholarPubMed
Chao, AS, Chao, A, Wang, TH, et al. Outcome of antenatally diagnosed cardiac rhabdomyoma: case series and a meta-analysis. Ultrasound Obstet Gynecol 2008; 31: 289295.CrossRefGoogle ScholarPubMed