Secondary Cardiac Tumor in Children

Abstract

We describe our clinical experience of eight cases of secondary cardiac tumor. The pathology of the tumors were lymphoma (three), Wilms' tumor (two), malignant teratoma (one), neuroblastoma (one), and pleuropulmonary blastoma (one). Metastatic sites were the right atrium in Wilms' tumor and neuroblastoma, the left atrium in pleuropulmonary blastoma and malignant teratoma, and multiple sites in lymphoma. Primary masses in the mediastinum extended directly to the heart (three lymphoma, malignant teratoma, pleuropulmonary blastoma). Wilms' tumor and neuroblastoma showed cardiac metastases through the inferior vena cava. Many cases revealed vague abnormal cardiovascular findings (symptoms in six; physical signs in five). In five cases surgery was performed to relieve the possible obstruction to flow and to identify the pathology (lymphoma in three, Wilms' tumor in one, and malignant teratoma in one). Chemotherapy prior to operation resulted in the disappearance of the intracardiac masses in each case of Wilms' tumor and pleuropulmonary blastoma. All three patients with lymphoma died immediately after operation. Four died of multiple metastases or Pneumocystis pneumonia several months after operation. This study indicates that suspicion of a secondary cardiac tumor is crucial to early diagnosis. Because of the poor postoperative outcome, surgery for secondary cardiac tumors should be done cautiously only in cases with definite hemodynamic decompensation.

Comportamiento clínico de los tumores cardíacos desde el feto hasta el adulto: serie multicéntrica de 38 pacientes

“…Llama la atención este hallazgo en la serie de adultos ya que está descrito que los tumores secundarios o metastásicos son entre 20 a 50 veces más frecuentes que los primarios 2,34,36 . No tenemos una explicación clara para este hecho, salvo que muchos de estos tumores no son diagnosticados, por corresponder a metástasis en una patología terminal no operable.…”

“…En niños se describen neuroblastomas y en adultos carcinomas y melanomas. La incidencia de linfomas cardíacos ha ido aumentando en el último tiempo, asociado al síndrome de inmunodeficiencia adquirida [34][35][36] . En esta serie se observaron 2 niños y seis adultos con tumores malignos secundarios, con 15% y 24%, respectivamente.…”

“…Los tumores primarios benignos son más frecuentes que los malignos, no obstante, los tumores benignos pueden evolucionar muy desfavorablemente, por los múltiples efectos hemodinámicos que pueden presentar [7][8][9][10][11][12][13][14] . Los tumores secundarios son 20 veces más frecuentes que los tumores primarios, pero muchas veces éstos no se diagnostican ni tratan, debido a que se presentan en pacientes con cáncer muy avanzado 2,34,36 .…”

Osteosarcoma with Cardiac Metastasis in a 22-year-old Man: A Case Report and Review of Cardiac Tumors

“…In children, the most common secondary cardiac tumor is metastasis from non‐Hodgkin's lymphoma. Others tumor sources include neuroblastoma, Wilms' tumor, malignant teratoma, and pleuropulmonary blastoma . Of note, non‐Hodgkin's lymphoma carries a higher incidence in immunocompromised patients as well as those infected with Epstein–Barr virus .…”

The Role of Echocardiography in Diagnosing Space-Occupying Lesions of the Heart

“…Common sources of metastatic cardiac tumor in the pediatric population includes lymphoma, Wilms' tumor, malignant teratoma, neuroblastoma and pleuropulmonary blastoma. 30 showing intramyocardial and, for right atrial masses, vena caval invasion. 5 The superior soft tissue characterization possible with CT and especially MRI also allows for the determination of the degree of tumor infiltration.…”