Abstract:

Objective

To retrospectively analyze the ultrasonographic characteristics and outcomes of primary cardiac tumors (PCTs) in children.

Methods

A total of 15 infants or children with PCTs who underwent surgery and pathology examination at Children’s Hospital Affiliated to Xi ’an Jiaotong University from March 2017 to May 2024 were retrospectively included in this study.Gender, clinical symptoms, and echocardiographic results, as well as tumor location, size, pathology, and prognosis, were analyzed.

Results

Among the 15 pediatric patients included, 12 (80.0%) had benign cardiac tumors (rhabdomyoma in 6 cases,fibroma in 2, myxoma in 2, hemangioma in 1, and lipoma in 1), 2 (13.3%) had intermediate-type tumors(inflammatory myofibroblastoma in both), and 1 (6.7%) had malignant cardiac tumor (CIC rearrangement sarcoma).Patients with rhabdomyoma exhibited lower age, body weight, and maximum tumor diameter compared to other pathological subtypes.Tumor distribution analysis showed solitary lesions in 12 cases and multiple lesions in 3.In total, there were 22 lesions, and the locations were as follows: 15 lesions in the left ventricle, 4 in the right ventricle, 1 in the left atrium, 1 in the right atrium, and 1 in the pericardium.Concomitant pericardial effusion was found in 3 cases.Preoperative echocardiography findings were coincident with pathological diagnoses in 9 cases (60.0%), with 4 misdiagnoses (2 solitary rhabdomyomas misdiagnosed as myxomas; 1 pedunculated capillary hemangioma misdiagnosed as myxoma; 1 inflammatory myofibroblastic tumor misdiagnosed as myxoma), and 2 cases remained undiagnosed.Partial tumor resection was performed in 3 cases, and complete resection in 12, with no perioperative mortality.The patient with malignant cardiac tumor died 5 months after operation, and the other 14 cases were alive, with no tumor recurrence or reoperation during 0.5 to 10 years of follow-up.

Conclusion

The majority of PCTs in children are benign, some of them have specific echocardiographic manifestations, and rare types need pathological examination for diagnosis.The prognosis of benign and intermediate PCTs in children undergoing surgical resection is satisfactory.

Key words: Child, Cardiac tumor, primary, Echocardiography