Primary Malignant Tumor of the Heart in Infancy

A 4-month-old boy with a sudden onset of heart failure, intractable to intensive therapy, presented the problem of differential diagnosis between anomalous origin of the left coronary artery from the pulmonary artery and tumor of the myocardium. At exploratory thoracotomy a tumor was found involving primarily the right ventricle but extending onto the left ventricle and engulfing the left coronary artery. Implants were seen in the pericardium and on the pulmonary artery, and at post-mortem examination metastases were observed in the lungs, regional lymph nodes and thymus. The pathologic diagnosis was rhabdomyosarcoma. Diagnosis and management of this and other cardiac neoplasms are discussed.