Primary cardiac tumors in early childhood
DOI:
https://doi.org/10.15574/SP.2025.6(150).7078Keywords:
heart tumors, children, diagnostics, echocardiography, magnetic resonance imaging, treatment, surgical intervention, tumor process, multidisciplinary approach, differential diagnosisAbstract
Primary cardiac tumors in children represent a rare but potentially life-threatening pathology that requires a high level of clinical vigilance and a multidisciplinary approach to diagnosis and treatment.
Aim - to analyze current data on the epidemiology, morphological types, clinical manifestations, diagnostic approaches, and management principles of primary cardiac tumors in young children (early childhood).
Primary cardiac tumors in children are uncommon, yet they demonstrate significant clinical and morphological variability. This review analyzes epidemiological patterns, evaluates diagnostic methods with proven effectiveness (fetal and postnatal echocardiography, magnetic resonance imaging), and outlines current approaches to surgical and conservative treatment. The article also highlights clinical scenarios where treatment decisions remain controversial due to the lack of standardized protocols.
Conclusions. Despite notable progress in diagnostic and therapeutic techniques, several aspects of managing primary cardiac tumors in children - particularly in early childhood - require further investigation. Key priorities include risk stratification, comparative evaluation of therapeutic strategies, and the development of diagnostic algorithms to ensure more individualized and evidence-based care for this complex patient population.
No conflict of interests was declared by the authors.
References
Behram M, Oğlak SC, Acar Z, Sezer S, Bornaun H et al. (2020). Fetal cardiac tumors: prenatal diagnosis, manage ment and prognosis in 18 cases. J Turk Ger Gynecol Assoc. 21(3): 147-152. https://doi.org/10.4274/jtgga.galenos.2020.2019.0180; PMid:33274615 PMCid:PMC7726467
Benavides AS, Oliva Rodríguez J, García Morejón C et al. (2009). Diagnóstico ecocardiográfico de los tumores primarios del corazón en el feto. Rev Cubana Obstet Ginecol. 35(1): 43-47.
Berghella V, Romeo R, Reedy M et al. (2001). Accuracy of prenatal diagnosis of congenital cardiac malformations by echocardiography. Obstet Gynecol. 98(4): 613-618.
Beroukhim RS, Ghelani SJ, Ashwath R et al. (2022). Accuracy of cardiac magnetic resonance imaging in diagnosing pediatric cardiac masses: A multicenter study. JACC Cardiovasc Imaging. 15(8): 1391-1405. https://doi.org/10.1016/j.jcmg.2021.07.010; PMid:34419404 PMCid:PMC11240235
Camargo FM, Brizot ML, Francisco RPV et al. (2024). Perinatal results and long-term follow-up of fetal cardiac tumors: A 30-year historical cohort study. Arq Bras Cardiol. 121(1): e20220469. https://doi.org/10.36660/abc.20220469; PMid:38536996 PMCid:PMC11081142
Carvalho S, Marcolin A, Cavalli R et al. (2010). Fetal cardiac rhabdomyoma: analysis of five cases. Rev Bras Ginecol Obstet. 32(2): 86-91. https://doi.org/10.1590/S0100-72032010000200006; PMid:20305946
Columbus M. (1562). De Re Anatomica. Venice: Vincentius Valgrisium.
DeVore GR. (1982). Prenatal diagnosis of a cardiac tumor by ultrasound. J Ultrasound Med. 1(3): 119-121.
Delmo Walter EM, Javier MF, Sander F et al. (2016). Primary cardiac tumors in infants and children: surgical strategy and long-term outcome. Ann Thorac Surg. 102(6): 2062-2069. https://doi.org/10.1016/j.athoracsur.2016.04.057; PMid:27344282
Donofrio MT, Moon-Grady AJ, Hornberger LK et al. (2014). Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation. 129(21): 2183-2242. https://doi.org/10.1161/01.cir.0000437597.44550.5d; PMid:24763516
Fan C, Gao Z, Yin N, Yang J. (2015). Surgical treatment of primary cardiac tumors in children: experience of a single institute. Oncol Lett. 10(4): 2390-2394. https://doi.org/10.3892/ol.2015.3529; PMid:26622798 PMCid:PMC4579805
Gu X, Han L, Chen J et al. (2018). Antenatal screening and diagnosis of tuberous sclerosis complex by fetal echocardiography and targeted genomic sequencing. Medicine (Baltimore). 97(30): e11740. https://doi.org/10.1097/MD.0000000000011740; PMid:30045342 PMCid:PMC6078736
Hinojosa Cruz JC, San Luis Miranda R, Veloz Martínez MG et al. (2006). Diagnostic and frequency of fetal heart disease by echocardiography. Ginecol Obstet Mex. 74(12): 611-618.
Holley DG, Martin GR, Brenner JI et al. (1995). Diagnosis and management of fetal cardiac tumors: a multicenter experience and review of published reports. J Am Coll Cardiol. 26(2): 516-520. https://doi.org/10.1016/0735-1097(95)80031-B; PMid:7608458
Kohut J, Krzystolik-Ładzińska J, Szydłowski L et al. (2010). The diagnosis, clinical course and follow-up of children with cardiac tumours: a single-centre experience. Kardiol Pol. 68(3): 304-309.
Koç M, Kutsal A. (2018). Rare operations in pediatric heart surgery: cardiac tumors in childhood. Turk Gogus Kalp Damar Cerrahisi Derg. 26(1): 151-156. https://doi.org/10.5606/tgkdc.dergisi.2018.16147; PMid:32082795 PMCid:PMC7018197
Kurmann R, El-Am E, Ahmad A et al. (2023). Cardiac masses discovered by echocardiogram; what to do next? Struct Heart. 7(4): 100154. https://doi.org/10.1016/j.shj.2022.100154; PMid:37520139 PMCid:PMC10382990
L'Angiocola PD, Donati R. (2020). Cardiac masses in echocardiography: A pragmatic review. J Cardiovasc Echogr. 30(1): 5-14. https://doi.org/10.4103/jcecho.jcecho_2_20; PMid:32766100 PMCid:PMC7307625
Liu X et al. (2015). Management of pediatric cardiac fibromas: experience of a single center. Ann Thorac Surg. 99(5): 1712-1718.
Mahaim I. (1945). Les tumeurs primaires du cœur. Paris: Masson.
Martínez-García A, Cervantes-Salazar J, Copado-Mendoza DY et al. (2023). Prenatal diagnosis and outcome of intrapericardial teratoma: report of two clinical scenarios. World J Pediatr Congenit Heart Surg. 14(1): 88-90. https://doi.org/10.1177/21501351221129189; PMid:36250319
Medina Perez M et al. (2021). Pediatric cardiac tumors: clinical findings and surgical outcomes. Rev Chil Cardiol. 40(3): 210-218.
Miyake CY, Del Nido PJ, Alexander ME et al. (2011). Cardiac tumors and associated arrhythmias in pediatric patients, with observations on surgical therapy for ventricular tachycardia. J Am Coll Cardiol. 58(19): 1903-1909. https://doi.org/10.1016/j.jacc.2011.08.005; PMid:22018302
Moradian M, Rafati M, Alizadehasl A et al. (2020). Pediatric cardiac tumors: clinical and echocardiographic features. J Tehran Heart Cent. 15(1): 13-18.
Morgagni GB. (1762). De Sedibus et Causis Morborum per Anatomen Indagatis. Venice: Remondini.
Morka A, Kohut J, Radzymińska-Chruściel B et al. (2020). Echocardiography and newer imaging techniques in diagnosis and long-term follow-up of primary heart tumors in children. Int J Environ Res Public Health. 17(15): 5471. https://doi.org/10.3390/ijerph17155471; PMid:32751243 PMCid:PMC7432637
Nathan M, Fabozzo A, Geva T et al. (2014). Successful surgical management of ventricular fibromas in children. J Thorac Cardiovasc Surg. 147(4): 1318-1323. https://doi.org/10.1016/j.jtcvs.2013.11.052; PMid:24507403
Neuhold A, Frank H. (2021). Imaging of primary cardiac tumors with MRI and CT: from basic to advanced techniques. Curr Cardiol Rep. 23(7): 91.
Nield LE, Mendelson M, Ahmad N et al. (2014). Clinical review of obstructive primary cardiac tumors in childhood. Congenit Heart Dis. 9(3): 244-251. https://doi.org/10.1111/chd.12134; PMid:23962026
Okmen F, Ekici H, Hortu I et al. (2020). Outcomes of antenatally diagnosed fetal cardiac tumors: a 10-year experience. J Matern Fetal Neonatal Med. 33(20): 3415-3420. https://doi.org/10.1080/14767058.2019.1582633; PMid:30760078
Ozkutlu S, Saraçlar M et al. (2005). Prenatal and postnatal echocardiographic diagnosis of cardiac tumors. Turk J Pediatr. 47(3): 232-238.
Padalino M et al. (2013). Surgical management of cardiac tumors in children: 25-year experience. Cardiol Young. 23(5): 632-639.
Paramés F, Freitas I, Martins JD, Trigo C, Pinto MF. (2009). Cardiac tumors: The 17-year experience of pediatric cardiology department. Rev Port Cardiol. 28(9): 929-940. PMID: 19998805.
Pasierb M, McNamara M, Wong M et al. (2018). The role of regional prenatal cardiac screening for congenital heart disease: a single center experience. Congenit Heart Dis. 13(6): 931-936. https://doi.org/10.1111/chd.12627; PMid:30033686
Pavlíček P, Hornychová H, Hájek T et al. (2019). Fetal cardiac tumors: 30 years of experience. Prenat Diagn. 39(13): 1133-1140.
Pino PG, Moreo A, Lestuzzi C. (2022). Differential diagnosis of cardiac tumors: General consideration and echocardiographic approach. J Clin Ultrasound. 50(8): 1177-1193. https://doi.org/10.1002/jcu.23309; PMid:36218203 PMCid:PMC9828386
Polymerou I, Ojala T, Bonou P et al. (2019). Successful treatment of cardiac haemangiomas with oral propranolol: a case series of two patients. Eur Heart J Case Rep. 3(2): ytz093. https://doi.org/10.1093/ehjcr/ytz093; PMid:31449646 PMCid:PMC6601147
Qiu L, Sun Y, Ding W, Xu Z, Liu J. (2011). Treatment strategies for pediatric patients with primary cardiac tumors. Zhonghua Wai Ke Za Zhi. 49(5): 414-417.
Rienmüller R, Lloret JL, Tiling R et al. (1989). MR imaging of pediatric cardiac tumors previously diagnosed by echocardiography. J Comput Assist Tomogr. 13(4): 621-626. https://doi.org/10.1097/00004728-198907000-00012; PMid:2745780
Sheppard MN. (2005). Cardiac tumours - diagnosis and management. Heart. 91(2): 218-224.
Sugalska M, Tomik A, Jóźwiak S, Werner B. (2021). Treatment of cardiac rhabdomyomas with mTOR inhibitors in children with tuberous sclerosis complex: a systematic review. Int J Environ Res Public Health. 18(9): 4907. https://doi.org/10.3390/ijerph18094907; PMid:34062963 PMCid:PMC8124908
Tao TY, Yahyavi-Firouz-Abadi N, Singh GK, Bhalla S. (2014). Pediatric cardiac tumors: clinical and imaging features. Curr Probl Diagn Radiol. 43(4): 115-123. https://doi.org/10.1148/rg.344135163; PMid:25019440
Uzun O, Wilson DG, Vujanic GM, Parsons JM, De Giovanni JV. (2007). Cardiac tumours in children. Orphanet J Rare Dis. 2: 11. https://doi.org/10.1186/1750-1172-2-11; PMid:17331235 PMCid:PMC3225855
Walshe W. (1867). On cancerous and other tumours of the heart. Trans Pathol Soc Lond. 18: 275-288.
Ying L, Lin R, Gao Z, Qi J, Zhang Z, Gu W. (2016). Primary cardiac tumors in children: A center's experience. J Cardiothorac Surg. 11(1): 127. https://doi.org/10.1186/s13019-016-0448-5; PMid:27067427 PMCid:PMC4827228
Yuan SM. (2018). Fetal cardiac tumors: clinical features, management and prognosis. J Perinat Med. 46(2): 115-121. https://doi.org/10.1515/jpm-2016-0311; PMid:28343178
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Modern pediatrics. Ukraine

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.