Laura Linnemeier1, Brian D Benneyworth2, Mark Turrentine1, Mark Rodefeld1, John Brown3. 1. Department of Cardiovascular Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. 2. Department of Cardiovascular Surgery, Indiana University School of Medicine, Indianapolis, IN, USA Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA. 3. Department of Cardiovascular Surgery, Indiana University School of Medicine, Indianapolis, IN, USA jobrown@iupui.edu.
Abstract
BACKGROUND: Cardiac tumors in children are rare. Of the cases reported in the literature, nearly all are benign and managed conservatively. METHODS: This is a retrospective, observational study of pediatric patients <18 years who presented for surgical evaluation of a cardiac tumor, between 1969 and 2014 at a tertiary care children's hospital. Presentation, pathology, management, and outcomes were evaluated. RESULTS: Over the last 45 years, 64 patients were evaluated for surgical resection of a cardiac tumor. Rhabdomyoma was the most common neoplasm (58%), and 17% of the tumors had malignant pathologies. While 42% of benign cardiac neoplasms required surgical intervention for significant hemodynamic concerns, 73% of malignant neoplasms underwent radical excision, if possible, followed by adjuvant chemotherapy. Despite a 37% mortality in patients with malignant pathology, an aggressive surgical approach can yield long-term survival in some patients. There were no deaths among patients with benign tumors and 17% had postoperative complications mostly related to mitral regurgitation. CONCLUSION: Cardiac tumors in children are rare but can be managed aggressively with good outcomes. Benign tumors have an excellent survival with most complications related to tumor location. Malignant tumors have a high mortality rate, but surgery and adjuvant chemotherapy allow for prolonged survival in selected patients.
BACKGROUND:Cardiac tumors in children are rare. Of the cases reported in the literature, nearly all are benign and managed conservatively. METHODS: This is a retrospective, observational study of pediatric patients <18 years who presented for surgical evaluation of a cardiac tumor, between 1969 and 2014 at a tertiary care children's hospital. Presentation, pathology, management, and outcomes were evaluated. RESULTS: Over the last 45 years, 64 patients were evaluated for surgical resection of a cardiac tumor. Rhabdomyoma was the most common neoplasm (58%), and 17% of the tumors had malignant pathologies. While 42% of benign cardiac neoplasms required surgical intervention for significant hemodynamic concerns, 73% of malignant neoplasms underwent radical excision, if possible, followed by adjuvant chemotherapy. Despite a 37% mortality in patients with malignant pathology, an aggressive surgical approach can yield long-term survival in some patients. There were no deaths among patients with benign tumors and 17% had postoperative complications mostly related to mitral regurgitation. CONCLUSION:Cardiac tumors in children are rare but can be managed aggressively with good outcomes. Benign tumors have an excellent survival with most complications related to tumor location. Malignant tumors have a high mortality rate, but surgery and adjuvant chemotherapy allow for prolonged survival in selected patients.
Authors: Radohery Lovasoa Randriamanga; Etienne Rakotomijoro; Mefiarisoa Bodo Anna Rakotonirina; Muriel Prudent Journal: Pan Afr Med J Date: 2022-01-11