Primary cardiac tumors in early childhood

Authors

DOI:

https://doi.org/10.15574/SP.2025.6(150).7078

Keywords:

heart tumors, children, diagnostics, echocardiography, magnetic resonance imaging, treatment, surgical intervention, tumor process, multidisciplinary approach, differential diagnosis

Abstract

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.

Author Biographies

N.M. Rudenko, Shupyk National Healthcare University of Ukraine, Kyiv

SI "Scientific and Practical Medical Center of Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine", Kyiv

O.M. Datsko, Shupyk National Healthcare University of Ukraine, Kyiv

SI "Scientific and Practical Medical Center of Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine", Kyiv

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

Published

2025-12-22