Cardiac Fibroma, a Rare Primary Tumour- A Case Report

Abstract

A 5-year-old female child presented with easy fatiguability, fever and chest pain of 2 months' duration, prior to which she was asymptomatic. This rare way of presentation of the child made us document the data. The child was immunised for age. She was active, alert and had attained developmental milestones for her age. On systemic examination, shape of the chest appeared normal with no precordial bulging. On palpation, Apex beat was palpable at left 5 th intercostal space at the midclavicular line. There was no evidence of parasternal heave and thrill on examination. First and second heart sounds were heard in all the four cardiac areas and were of normal intensity. Ejection systolic murmur was heard in the 2 nd left intercostal space. Echocardiography revealed dilated, well-circumscribed, homogeneous mass attached to the right ventricular outflow tract causing mild obstruction. Cardiac fibroma, also known as Fibrous hamartoma is a rare primary tumour encountered in infants and children without gender predilection. Fibromas are solitary tumours that are derived from fibroblasts and connective tissue with a matrix containing collagen, located mainly in the ventricular septum. [1] Macroscopically, they present as rounded, white fibrous masses whorled on cut surface. The margin may be either circumscribed or infiltrative. Histologically, fibromas are composed of bland appearing spindle shaped cells arranged in loose intersecting fascicles, which may extend into the surrounding myocardium. A 5-year-old child was referred to the tertiary care hospital, presented with chest pain of 2 months' duration. Echocardiography revealed dilated, homogeneous, well-circumscribed mass attached to the right ventricle with mild right ventricular outflow obstruction. Diagnosis of cardiac fibroma requires a high index of suspicion and correlation with physical and echocardiographic findings. Following surgical excision and histopathological confirmation, the prognosis was excellent.