Literature survey on epidemiology and pathology of cardiac fibroma

Abstract

BackgroundAlthough cardiac fibroma has been regarded as benign tumor, it presents various symptoms and may lead to death. Unfortunately, only a few studies have reported the epidemiology, embryology, and histopathology of the tumor, and the factors predicting poorer outcome are still obscured.MethodsIn July 2011 we searched for English and Japanese cases of cardiac fibroma using the PubMed and IgakuChuoZasshi databases. We then extracted and sampled raw data from the selected publications in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) style as much as was possible.ResultsDetails of a total of 178 patients with cardiac fibroma were retrieved. The mean age was 11.4 years (median: 2.8 years). Tumor sizes ranged from 8.0 to 150.0 mm (mean 53.1 mm). The left ventricle was found to be the most common site associated with the tumor at a rate of 57.3%, followed by the right ventricle, and interventricular septum. The highest mortality was found in patients with septal involvement (58.6%). In all, 111 patients survived among the 160 patients with a recorded outcome. A younger age of the patient at the time of diagnosis was associated with a decreased survival rate. In addition, a significant positive association was found between ages for patients younger than 17 years of age and the diameter of the tumor at the time of diagnosis (r = 0.341, P = 0.006).ConclusionsBoth the younger age of patients at the time of diagnosis and septal involvement can be regarded as factors significantly indicating a poor prognosis. Furthermore, our statistical analyses support the following hypotheses. First, the high ratio of tumor-to-heart size may generate low cardiac output and therefore lead to poor outcome. Second, the ratio of the sites where cardiac fibroma occurred corresponds with the ratio of the muscular weight of the cardiac chamber. Third, cardiac fibroma involving the interventricular septum more frequently induces conduction system disease.

Right Ventricular Reconstruction After Resection of Cardiac Fibroma

“…It typically presents during childhood and patients have a mean age at operation of 11-18 years. 1,4,6 The knowledge pertaining to surgical management of cardiac fibromas in adults is limited to case reports and reviews of the literature. 7,8 Cardiac fibromas can occur in the atria, interventricular septum, or ventricle.…”

“…7,8 Cardiac fibromas can occur in the atria, interventricular septum, or ventricle. 6 They most commonly originate in the left ventricle. 7 Our case of a RV fibroma is an uncommon occurrence.…”

Clinicopathologic Review of Non-Myxoma Cardiac Tumors: A 10-Year Single-Center Experience

“…Cardiac fibromas are regarded as benign tumors, although there are several associated factors predicting poorer outcome, including younger age at diagnosis and septal involvement [17]. Our only patient with a cardiac fibroma was diagnosed at the early age of 13 years owing to extensive tumor growth in the relatively small heart of a teenager.…”

“…Depending on the location of the tumor in the heart, the presenting symptoms may vary extensively [1,5,6,11,13,17,18]. In our study, all patients (100%) presented with dyspnea on admission, followed by chest pain (43.5%), cough (43.5%), orthopnea (17.4%), sweating (13%), palpitations (8.7%), nausea (8.7%), vomiting (4.3%), fever (4.3%), lymphadenopathy (4.3%) and palpable mass (4.3%).…”

Cardiac fibroma mimicking hypertrophic cardiomyopathy in a 5-month-old infant

“…They show a high possibility of affecting the conduction system, which results in arrhythmia, conduction blocking and ventricular tachycardia that may cause sudden death, which occurs in one-third of the patients [3]. A study has shown that a fibroma located in the septal regions is a significant prognostic factor due to its high tendency for arrhythmias [7]. It may block the outflow or inflow tracts, influencing the hemodynamics, which results in chest pain, shortness of breath or even heart failure.…”