Giant Cardiac Fibroma: An Unusual Cause of Failure to Thrive

Abstract

Cardiac fibromas are extremely rare in the general pediatric population and may present with a wide spectrum of clinical signs, including life-threatening arrhythmias and sudden death. We report a 14-month-old boy who presented with failure to thrive as the only symptom. Echocardiography showed a large cardiac fibroma in the right ventricle. Cardiac magnetic resonance imaging confirmed the diagnosis. After complete surgical tumor resection, the boy showed normal catch-up growth. This case underlines the diversity of clinical features of cardiac tumors, which implies that they should be considered early in the differential diagnosis of infants with failure to thrive.

Giant Right Ventricular Fibroma: Prenatal Diagnosis and Partial Resection in Early Infancy

“…1,6,7 Tumor compression may limit both diastolic filling and ventricular emptying, leading to clinical signs of heart failure, arrhythmias and sudden death. 3,7,8 In our case, CF was located on the anterior wall of the RV with progressive growth leading to heart failure at four months of age.…”

“…Long-term follow-up is necessary to monitor for arrhythmia, RV inflow/outflow obstruction, and valvar function. [1][2][3]7 In our patient, complete resection was not possible due to tumor infiltration of the RV free wall, proximity of tricuspid annulus, and involvement of the coronary artery branches. Therefore, extensive debulking was undertaken to achieve partial resection.…”

“…Being the second most common tumor, cardiac fibromas (CFs) are rarely encountered in children and even more infrequently in neonates. [1][2][3] Although CFs are benign, prognosis depends on tumor characteristics, size, and location. They are commonly located in the left ventricle and less commonly involve the right ventricle (RV) or atrium.…”