Key result
Infant benign primary cardiac tumors demonstrate ~82% survival despite frequent surgical intervention.
Observational (n=14)
No
Benign primary cardiac tumors in infants have a diverse clinical course with a 20% hospital mortality rate, highlighting the importance of prenatal diagnosis for planning neonatal management.
Case series of 14 pediatric primary cardiac tumors supports prenatal diagnosis feasibility; leaves open need for larger studies on outcomes.
Background: Primary cardiac tumors (PCT) in children are rare disorders.Prenatal diagnosis is feasible.Most of them have favorable prognosis, but some still prove fatal.Objective: To define clinical outcome of benign PCT and the possible impact of prenatal diagnosis.Methods: 14 cases were collected between December 2005 and August 201.We included patients with pre and postnatal diagnosis, medically and surgically managed.Pre and postnatal examinations, surgical procedures, clinical information before and after surgery, histological diagnoses were reviewed.Results: Seventy-two percent of PCT were detected prenatally.Median follow-up time was 3,13 years.In the medical managed group, one had complete spontaneous regression, 3 had spontaneous reduction, 2 underwent efficacious Enviroximes treatment and one was lost to follow-up.46% of cases needed surgery.In two infants, perioperative support with V-A ECMO and iNO was necessary.Complete excision of the mass was possible in 5 cases.Rate of hospital death was 20%.All but one late survivors were symptom-free at last clinical assessment.Clinical relevant recurrence of mixoma occurred in one case.Conclusion: Benign PCT have extremely diverse course, some proving fatal in spite of benign histology.Prenatal diagnosis is crucial to plan delivery and neonatal management, as some benign PCT require intensive care.Complete excision of the mass usually is feasible but may be limited by young age and extent of cardiac infiltration.Even if patients are generally well after surgery, long term follow up is mandatory as some masses recur.
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Giovanni Battista Luciani (2018) conducted an observational in Primary cardiac tumors (PCT) (n=14). Prenatal diagnosis vs. Postnatal diagnosis was evaluated on Clinical outcome (survival, need for surgery, and tumor regression). Among 14 infants with benign primary cardiac tumors, 72% were diagnosed prenatally, 46% required surgical intervention, and overall survival was 82% at a median follow-up of 3.1 years.
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