A Rare Case of Multiple Intracardiac Tumors in Pediatric

Author : B. Saunders, I. Sulistyorini I. Mappangara, Y. Patimang, B. Iskandar
Upload Date : 19-04-2018

Background: The incidence of multiple intracardiac tumors is very rare. The frequency of primary cardiac tumors about 0.0017-0.28% based on autopsies. Secondary tumors are 10-40 times more frequent. The occurrence rate in children is approximately 0.027%. Among the pediatric population, more than 90% of cardiac neoplasms are histologically benign. Diagnosis is a challenge for any physician because cardiac tumors have no typical presentation or asymptomatic. Some authors call heart neoplasms the great masqueraders.

Case Report: We report the case of a 3-month-old baby girl was admitted to our hospital for  transthoracic echocardiography. The pediatrician found a pathologic heart sound. She had no cardiac symptoms. Her physical examination was normal except the systolic murmur. A transthoracic echocardiogram revealed a  3.08 x 1.50 cm , lobulated, mobile, echogenic mass within the left ventricle, oscilating toward the LVOT and causing mild obstruction and a  1.69 x 1.06 cm, mobile, echogenic mass within the right ventricle with no obstruction. She needs complete resection of the tumors when become symptomatic or increase of obstruction gradient or increase of tumors size. 

Discussion: Most of ventricular tumors present with signs and symptoms such as syncope, seizure, thromboembolism, arrhythmias, congestive heart failure, and sudden death. Conversely, our patient was symptomatic and had been referred for routine evaluation of an incidental cardiac murmur. Upon further investigation with echocardiography, the patient was found to have multiple large tumor in the LV and RV, partially obstructing the LVOT. Echocardiography offers a noninvasive alternative for comprehensive cardiac evaluation and provides several advantages to diagnose the cardiac tumors.

Conclusion: Left ventricular and right ventricular tumors occurs at the same patients are extremely rare. Echocardiography has become the first line of diagnostic evaluation for the cardiologist. The most effective noninvasive imaging approach to detect the presence of cardiac structural problems especially in pediatric.

KEYWORDS : Intracardiac tumors, ventricle, echocardiography, pediatric

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