Abstract
Heart tumors in children are extremely rare pathologies and occur in pediatric practice with a frequency of 0.017–5% of cases. The vast majority of primary heart tumors in children are benign, while approximately 10% are malignant. At the same time, secondary malignant tumors are 10 times more common than primary ones. Due to the small number of clinical observations, as well as the characteristics of the body, the diagnosis of this pathology does not have generally recognized algorithms. First of all, the difficulty in diagnosing heart tumors is associated with the non-specific clinical manifestations and asymptomatic course of the disease in the early stages. This article analyzes the effectiveness of various methods of examination of young children with heart neoplasms to optimize the diagnostic approach, which will further improve the early detection of this disease and choose the tactics of timely treatment.
References
- Бокерия Л.А., Малашенков А.И., Кавсадзе В.Э., Серов P.A. Кардиоонкология. М.: НЦССХ им. А.Н. Бакулева РАМН; 2003.
- Тевосов Д.Р., Хугаев Г.А., Воронцова М.М., Сухачева Т.В., Серов Р.А. Онкопатология сердца в структуре биопсийного и операционного материала НМИЦССХ им. А.Н. Бакулева за период с 2000 по 2016 годы. Сердечно-сосудистые заболевания. Бюллетень НЦССХ им. А.Н. Бакулева РАМН. 2018; 19 (56): 238.
- Шаталов К.В., Арнаутова И.В., Заграй А.В., Гамисония А.М., Тевосов Д.Р. Случай успешной резекции фибромы межжелудочковой перегородки с обструкцией выводного отдела правого желудочка у ребенка 1 года 3 месяцев.
- Shi L., Wu L., Fang H., Han B., Yang J., Ma X. et al. Identification and clinical course of 166 pediatric cardiac tumors. Eur. J. Pediatr. 2017; 176 (2): 253–60. DOI: 10.1007/s00431-016-2833-4
- Бокерия Л.А., Бокерия О.Л., Рубцов П.П., Ахобеков А.А. Опыт лечения рабдомиом сердца в сочетании с нарушениями ритма у детей. Анналы аритмологии. 2014; 11 (4):
204–12. DOI: 10.15275/annaritmol.2014.4.3
- Kieu V., Czosek R.J., Knilans T.K., Quintessenza J.A., Bryant R., Mohan Sh. Venoarterial extracorporeal membrane oxygenation and implantable cardioverter-defibrillator implantation
in a hemodynamically unstable infant with ventricular tachycardia from multiple cardiac rhabdomyomas. 2019; 5: 196–200. DOI: 10.1016/j.hrcr.2018.12.009
- Jones J.P., Ramcharan T., Chaudhari M., Bhole V., Mcleod K., Sadagopan Sh. et al. Ventricular fibromas in children, arrhythmia risk, and outcomes: A multicenter study. Heart Rhythm. 2018; 15 (10): 1507–12. DOI: 10.1016/j.hrthm.2018.06.018
- Свободов А.А., Докторова В.П. Первичные опухоли сердца у новорожденных и грудных детей: история вопроса, методы диагностики, показания к хирургическому лечению. Детские болезни сердца и сосудов. 2015; 3: 24–31.
- Sciacca P., Giacchi V., Mattia C., Greco F., Smilari P., Betta P. et al. Rhabdomyomas and tuberous sclerosis complex: our experience in 33 cases. BMC Cardiovasc. Disord. 2014; 14:
16. DOI: 10.1186/1471-2261-14-66
- Davis P.E., Filip-Dhima R., Sideridis G., Peters J.M., Au K.S., Northrup H. et al. Presentation and diagnosis of tuberous sclerosis complex in infants. Pediatrics. 2017; 140 (6).
DOI: 10.1542/peds.2016-4040
- Chadha R., Johnsson J.-A., Fruitman D., Cooper S.L., Wei X.-C., Bernier F. A rare case of cardiac rhabdomyomas in a dizygotic twin pair. J. Obstet. Gyneacol. Can. 2011; 33 (8): 854–7.
12. Yuan S.-M. Fetal primary cardiac tumors during perinatal period. Pediatr. Neonatol. 2017; 58: 205–10.
- Sandrini C., Hoxha S., Rossetti L., Pilati M., Prioli M.A., Ribichini F.L. et al. Clinical outcome of benign cardiac tumors in infants during a 13 years' experience: impact of prenatal diagnosis.
Biomed. J. 2018; 7 (2). DOI: 10.26717/BJSTR.2018.07.001483
- Ramush B., Retkoceri R., Bejiqi H. Prenatally diagnosis and outcome of fetuses with cardiac rhabdomyoma – single centre experience. J. Med. Sci. 2017. DOI: 10.3889/oamjms.2017.040
- Miyake C.Y., Del Nido P.J., Alexander M.E., Cecchin F., Berul Ch.I., Triedman J.K. et al. Cardiac tumors and associated arrhythmias in pediatric patients, with observations on surgical
therapy for ventricular tachycardia. J. Am. Coll. Cardiol. 2011; 58: 1903–9. DOI: 10.1016/j.jacc.2011.08.005
- Nathan M., Fabozzo A., Geva T., Walsh E., del Nido P.J. Successful surgical management of ventricular fibromas inchildren. J. Thorac. Cardiovasc. 2014; 148 (6): 2602–8.
DOI: 10.1016/j.jtcvs.2013.11.052
- Miyake Ch.Y., Del Nido P.J., Alexander M.E., Cecchin F., Berul Ch.I., Triedman J.K. et al. Cardiac tumors and associated arrhythmias in pediatric patients, with observations on surgical
therapy for ventricular tachycardia. J. Am. Coll. Cardiol. 2011; 58 (18): 1903–9. DOI: 10.1016/j.jacc.2011.08.005
- Chinawa J.M., Garekar S., Trivedi B. Large cardiac rhabdomyoma in two infants: Good response to medical management – A brief report. Nig. J. Cardiol. 2017; 14: 106–8.
- Jones J.P., Ramcharan T., Chaudhari M., Bhole V., Mcleod K., Sadagopan Sh. et al. Ventricular fibromas in children, arrhythmia risk, and outcomes: A multicenter study. Heart Rhythm. 2018; 10: 1507–12. DOI: 10.1016/j.hrthm.2018.06.018
- Kwiatkowska J., Wałdoch A., Meyer-Szary J., Potaż P. Cardiac tumors in children: A 20-year review of clinical presentation, diagnostics and treatment. Adv. Clin. Exp. Med. 2017; 26 (2):
319–26. DOI: 10.17219/acem/62121
- Сухарева Г.Э. Опухоли сердца у детей – редкая врожденная патология сердечно-сосудистой системы. Часть 1. Здоровье ребенка. 2012; 6 (41): 189–97.
- Penha J.G., Zorzanelli L., Barbosa-Lopes A.A., Aiello V.D., Carvalho V.O., Caneo L.F. et al. Heart neoplasms in children: retrospective analysis. Arq. Bras. Cardiol. 2013; 100 (2):
120–6. DOI: 10.5935/abc.20130024
- Tao T.Y., Yahyavi-Firouz-Abadi N., Singh G.K., Bhalla S. Pediatric cardiac tumors: clinical and imaging features. Radio-Graphics. 2014; 34: 1031–46. DOI: 10.1148/rg. 344135163
- Ramadani N., Kreshnike K.D., Muçaj S., Kabashi S., Hoxhaj A.,Jerliu N. et al. MRI verification of a case of huge infantile rhabdomyoma. Acta Inform. Med. 2016; 24 (2): 146–8.
DOI: 10.5455/aim.2016.24.146-148
- Chinawa J.M., Garekar S., Trivedi B. Large cardiac rhabdomyoma in two infants: Good response to medical management – Abrief report. Nig. J. Cardiol. 2017; 14: 106–8.
- Li W., Teng P., Xu H., Ma L., Ni Y. Cardiac hemangioma: a comprehensive analysis of 200 cases. Ann. Thorac. Surg. 2015; 99: 2246–52. DOI: 10.1016/j.athoracsur.2015.02.064
- Конради Ю.В., Рыжкова Д.В. Лучевая диагностика опухолей сердца. Трансляционная медицина. 2015; 2 (4): 28–40.
- Yosra M., Hela M., Kaouthar H., Lilia Ch., Fatma O. Echocardiographic study of heart rhabdomyoma: from fetuses to children. Eur. Heart J. 2017. DOI: 10.1093/eurheartj/ehx493.P6305
- ElBardissi A.W., Dearani J.A., Daly R.C., Mullany C.J., Orszulak T.A., Puga F.J. et al. Survival after resection of primary cardiac tumors a 48-year experience. Circulation. 2008;
118: S7–15. DOI: 10.1161/CIRCULATIONAHA.107.783126
- Wu P.W., Chen Sh.-J., Lin W.-Ch., Chang Ch.-B., Chuang W.-Y., Hsu M.-Y. et al. Imaging of cardiac and pericardial masses. 2017; 1 (1): 23–37. DOI: 10.22468/cvia.2016.00059
- Mahani M.G., Lu J.C., Rigsby C.K., Krishnamurthy R., Dorfman A.L., Agarwal P.P. MRI of pediatric cardiac masses. Am. J. Roentgenol. 2014; 202: 971–81. DOI: 10.2214/AJR.13.10680
- Beroukhim R.S., Prakash A., Buechel E.R., Cava J.R., Dorfman A.L., Festa P. et al. Characterization of cardiac tumors in children by cardiovascular magnetic resonance
imaging: a multicenter experience. J. Am. Coll. Cardiol. 2011; 58 (10): 1044–54. DOI: 10.1016/j.jacc.2011.05.027
- Uzun O., Wilson D.G., Vujanic G.M., Parsons J.M., De Giovanni J.V. Cardiac tumours in children. Orphan. J. Rare Dis. 2007; 2: 11. DOI: 10.1186/1750-1172-2-11
- Liu X., Hong H., Zhang H., Xu Zh., Liu J., Qiu L. Treatment strategies for primary tumors of the heart in children: a 10 year experience. Pediatr. Cardiol. 2008. 29 (6): 1071–6.
DOI: 10.1016/j.athoracsur.2015.06.030
- Bu H., Gong Y., Xie L. Partial resection of a huge left ventricle cardiac fibroma in an asymptomatic child. Ann. Thorac. Surg. 2019; 108 (6): e393–5. DOI: 10.1016/j.athoracsur.2019.
04.035
- Li T., Liu C., Luo Y., Gong S., Xiao Y., Wang X., Wang Y. Retrospective analysis of 11 cases of primary cardiac valve tumors. Anatol. J. Cardiol. 2018; 21 (1): 11–7. DOI: 10.14744/
AnatolJCardiol.2018.40325
- Careddu L., Oppido G., Petridis F.D., Liberi R., Ragni L., Pacini D. et al. Primary cardiac tumours in the paediatric population. Multimed. Man. Cardiothorac. Surg. 2013; 2013:mmt013.
DOI: 10.1093/mmcts/mmt013
- Оджарова А.А., Долгушин М.Б., Поляков В.Г. Позитронная эмиссионная томография в детской онкологии. Материалы VI съезда детских онкологов с международным участием.
Москва 2015. Онкопедиатрия. 2015; 2 (3): 314–5.
- Ermek T., Aybek N., Zhang W., Guo Y.-Zh., Guo Sh., Mamataly A. et al. A rare case of biventricular myxoma. J. Cardiothorac. Surg. 2017; 12: 17. DOI: 10.1186/s13019-017-0584-6
References
- Bockeria L.A., Malashenkov A.I., Kavsadze V.E., Serov P.A.Cardionkology. Moscow; 2003 (in Russ.).
- Tevosov D.R., Khugaev G.A., Vorontsova M.M., Sukhacheva T.V., Serov R.A. Cardiac oncopathology in the structure of biopsy and operating material of the Bakoulev National Medical Research Center for Cardiovascular Surgery for the period from 2000 to 2016. The Bulletin of Bakoulev Center for Cardiovascular Diseases. 2018; 19 (56): 238 (in Russ.).
- Shatalov K.V., Arnautova I.V., Zagrai A.V., Gamisonia A.M., Tevosov D.R. A case of successful resection of interventricular septal fibroma with right ventricular outflow obstruction in a child of 1 year 3 months., Bulletin of the Bakulev national research center of the Russian Academy of medical Sciences. Cardiovascular diseases. 2018; 19 (3): 363–7. DOI: 10.24022/1810-0694-2018-19-3-363-367 (in Russ.).
- Shi L., Wu L., Fang H., Han B., Yang J., Ma X. et al. Identification and clinical course of 166 pediatric cardiac tumors. Eur. J. Pediatr. 2017; 176 (2): 253–60. DOI: 10.1007/s00431-016-2833-4
- Bockeria L.A., Bockeria O.L., Rubtsov P.P., Akhobekov A.A. Experience of treatment of rhabdomyoma of the heart in combination with arrhythmias in children. Аnnals of Arrhythmology. 2014; 11 (4): 204–12. DOI: 10.15275/annaritmol.2014.4.3 (in Russ.).
- Kieu V., Czosek R.J., Knilans T.K., Quintessenza J.A., Bryant R., Mohan Sh. Venoarterial extracorporeal membrane oxygenation and implantable cardioverter-defibrillator implantation in a hemodynamically unstable infant with ventricular tachycardia from multiple cardiac rhabdomyomas. 2019; 5: 196–200. DOI: 10.1016/j.hrcr.2018.12.009
- Jones J.P., Ramcharan T., Chaudhari M., Bhole V., Mcleod K., Sadagopan Sh. et al. Ventricular fibromas in children, arrhythmia risk, and outcomes: A multicenter study. Heart Rhythm. 2018; 15 (10): 1507–12. DOI: 10.1016/j.hrthm.2018.06.018
- Svobodov A.A., Doktorova V.P. Primary heart tumors in newborns and infants: background, diagnostic methods, indications for surgical treatment. Children's Heart And Vascular
Diseases. 2015; 3: 24–31 (in Russ.).
- Sciacca P., Giacchi V., Mattia C., Greco F., Smilari P., Betta P. et al. Rhabdomyomas and tuberous sclerosis complex: our experience in 33 cases. BMC Cardiovasc. Disord. 2014; 14:
16. DOI: 10.1186/1471-2261-14-66
- Davis P.E., Filip-Dhima R., Sideridis G., Peters J.M., Au K.S., Northrup H. et al. Presentation and diagnosis of tuberous sclerosis complex in infants. Pediatrics. 2017; 140 (6). DOI: 10.1542/peds.2016-4040
- Chadha R., Johnsson J.-A., Fruitman D., Cooper S.L., Wei X.-C., Bernier F. A rare case of cardiac rhabdomyomas in a dizygotic twin pair. J. Obstet. Gyneacol. Can. 2011; 33 (8): 854–7.
12. Yuan S.-M. Fetal primary cardiac tumors during perinatal period. Pediatr. Neonatol. 2017; 58: 205–10.
- Sandrini C., Hoxha S., Rossetti L., Pilati M., Prioli M.A., Ribichini F.L. et al. Clinical outcome of benign cardiac tumors in infants during a 13 years' experience: impact of prenatal
diagnosis. Biomed. J. 2018; 7 (2). DOI: 10.26717/BJSTR.2018.07.001483
- Ramush B., Retkoceri R., Bejiqi H. Prenatally diagnosis and outcome of fetuses with cardiac rhabdomyoma – single centre experience. J. Med. Sci. 2017. DOI: 10.3889/oamjms.2017.
- Miyake C.Y., Del Nido P.J., Alexander M.E., Cecchin F., Berul Ch.I., Triedman J.K. et al. Cardiac tumors and associated arrhythmias in pediatric patients, with observations on surgical therapy for ventricular tachycardia. J. Am. Coll. Cardiol. 2011; 58: 1903–9. DOI: 10.1016/j.jacc.2011.08.005
- Nathan M., Fabozzo A., Geva T., Walsh E., del Nido P.J. Successful surgical management of ventricular fibromas in children. J. Thorac. Cardiovasc. 2014; 148 (6): 2602–8. DOI: 10.1016/j.jtcvs.2013.11.052
- Miyake Ch.Y., Del Nido P.J., Alexander M.E., Cecchin F., Berul Ch.I., Triedman J.K. et al. Cardiac tumors and associated arrhythmias in pediatric patients, with observations on surgical
therapy for ventricular tachycardia. J. Am. Coll. Cardiol. 2011; 58 (18): 1903–9. DOI: 10.1016/j.jacc.2011.08.005
- Chinawa J.M., Garekar S., Trivedi B. Large cardiac rhabdomyoma in two infants: Good response to medical management – A brief report. Nig. J. Cardiol. 2017; 14: 106–8.
- Jones J.P., Ramcharan T., Chaudhari M., Bhole V., Mcleod K., Sadagopan Sh. et al. Ventricular fibromas in children, arrhythmia risk, and outcomes: A multicenter study. Heart Rhythm. 2018; 10: 1507–12. DOI: 10.1016/j.hrthm.2018.06.018
- Kwiatkowska J., Wałdoch A., Meyer-Szary J., Potaż P. Cardiac tumors in children: A 20-year review of clinical presentation, diagnostics and treatment. Adv. Clin. Exp. Med. 2017; 26 (2): 319–26. DOI: 10.17219/acem/62121
- Sukhareva G.E. Heart tumors in children – a rare congenital pathology of the cardiovascular system. Part 1. The health of the child. 2012; 6 (41): 189–97 (in Russ.).
- Penha J.G., Zorzanelli L., Barbosa-Lopes A.A., Aiello V.D., Carvalho V.O., Caneo L.F. et al. Heart neoplasms in children: retrospective analysis. Arq. Bras. Cardiol. 2013; 100 (2):
120–6. DOI: 10.5935/abc.20130024
- Tao T.Y., Yahyavi-Firouz-Abadi N., Singh G.K., Bhalla S. Pediatric cardiac tumors: clinical and imaging features. Radio-Graphics. 2014; 34: 1031–46. DOI: 10.1148/rg.344135163
- Ramadani N., Kreshnike K.D., Muçaj S., Kabashi S., Hoxhaj A., Jerliu N. et al. MRI verification of a case of huge infantile rhabdomyoma. Acta Inform. Med. 2016; 24 (2): 146–8.
DOI: 10.5455/aim.2016.24.146-148
- Chinawa J.M., Garekar S., Trivedi B. Large cardiac rhabdomyoma in two infants: Good response to medical management – Abrief report. Nig. J. Cardiol. 2017; 14: 106–8.
- Li W., Teng P., Xu H., Ma L., Ni Y. Cardiac hemangioma: a comprehensive analysis of 200 cases. Ann. Thorac. Surg. 2015; 99: 2246–52. DOI: 10.1016/j.athoracsur.2015.02.064
- Konradi Yu.V., Ryzhkova D.V. Radiation diagnostics of heart tumors. Trans. Med. 2015; 2 (4): 28–40 (in Russ.).
- Yosra M., Hela M., Kaouthar H., Lilia Ch., Fatma O. Echocardiographic study of heart rhabdomyoma: from fetuses to children. Eur. Heart J. 2017. DOI: 10.1093/eurheartj/ehx493.
P6305
- ElBardissi A.W., Dearani J.A., Daly R.C., Mullany C.J., Orszulak T.A., Puga F.J. et al. Survival after resection of primary cardiac tumors a 48-year experience. Circulation. 2008; 118: S7–15. DOI: 10.1161/CIRCULATIONAHA.107.783126
- Wu P.W., Chen Sh.-J., Lin W.-Ch., Chang Ch.-B., Chuang W.-Y., Hsu M.-Y. et al. Imaging of cardiac and pericardial masses. 2017; 1 (1): 23–37. DOI: 10.22468/cvia.2016.00059
- Mahani M.G., Lu J.C., Rigsby C.K., Krishnamurthy R., Dorfman A.L., Agarwal P.P. MRI of pediatric cardiac masses. Am. J. Roentgenol. 2014; 202: 971–81. DOI: 10.2214/AJR.13.
- Beroukhim R.S., Prakash A., Buechel E.R., Cava J.R., Dorfman A.L., Festa P. et al. Characterization of cardiac tumors in children by cardiovascular magnetic resonance
imaging: a multicenter experience. J. Am. Coll. Cardiol. 2011; 58 (10): 1044–54. DOI: 10.1016/j.jacc.2011.05.027
- Uzun O., Wilson D.G., Vujanic G.M., Parsons J.M., De Giovanni J.V. Cardiac tumours in children. Orphan. J. Rare Dis. 2007; 2: 11. DOI: 10.1186/1750-1172-2-11
- Liu X., Hong H., Zhang H., Xu Zh., Liu J., Qiu L. Treatment strategies for primary tumors of the heart in children: a 10-year experience. Pediatr. Cardiol. 2008. 29 (6): 1071–6.
DOI: 10.1016/j.athoracsur.2015.06.030
- Bu H., Gong Y., Xie L. Partial resection of a huge left ventricle cardiac fibroma in an asymptomatic child. Ann. Thorac. Surg. 2019; 108 (6): e393–5. DOI: 10.1016/j.athoracsur.2019.04.035
- Li T., Liu C., Luo Y., Gong S., Xiao Y., Wang X., Wang Y. Retrospective analysis of 11 cases of primary cardiac valve tumors. Anatol. J. Cardiol. 2018; 21 (1): 11–7. DOI: 10.14744/AnatolJCardiol.2018.40325
- Careddu L., Oppido G., Petridis F.D., Liberi R., Ragni L., Pacini D. et al. Primary cardiac tumours in the paediatric population. Multimed. Man. Cardiothorac. Surg. 2013; 2013:mmt013.
DOI: 10.1093/mmcts/mmt013
- Odzharova A.A., Dolgushin M.B., Polyakov V.G. Positron emission tomography in pediatric oncology, proceedings of the VI Congress of pediatric oncologists with international participation. Moscow 2015. Oncopediatrics. 2015; 2 (3): 314–5 (in Russ.).
- Ermek T., Aybek N., Zhang W., Guo Y.-Zh., Guo Sh., Mamataly A. et al. A rare case of biventricular myxoma. J. Cardiothorac. Surg. 2017; 12: 17. DOI: 10.1186/s13019-017-0584-6
About the authors
- Abdubanob Yu. Ergashov, Postgraduate, ORCID
- Svobodov Andrey Andreevich, Dr. Med. Sc., Chief Researcher, ORCID