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Large cardiac fibroma and teratoma in children- case reports.

Jha NK, Kiraly L, Tamas C, Talo H, Khan MD, El Badaoui H, Jain A, Hammad A - J Cardiothorac Surg (2015)

Bottom Line: There are several consecutive series published in the last decade on cardiac neoplasms.Therefore, this is not only an effort to contribute to the existing literature for better understanding and management of similar patients but also to highlight the importance of early detection either by prenatal imaging or careful evaluation of differential diagnosis of common symptoms.We herein, describe two infants with large cardiac tumours (fibroma and teratoma) both arising from the interventricular septum and underwent surgical excision.

View Article: PubMed Central - PubMed

Affiliation: Division of Paediatric Cardiac Surgery, Sheikh Khalifa Medical City (managed by Cleveland Clinic), PO Box-51900, Karamah Street, Abu Dhabi, United Arab Emirates. njha@skmc.ae.

ABSTRACT
Primary cardiac tumours in paediatric population are an unusual occurrence. Although, majority of such tumours are benign (90%), the frequency and type of cardiac tumours in this age group is different from the adult population. There are several consecutive series published in the last decade on cardiac neoplasms. Therefore, this is not only an effort to contribute to the existing literature for better understanding and management of similar patients but also to highlight the importance of early detection either by prenatal imaging or careful evaluation of differential diagnosis of common symptoms. We herein, describe two infants with large cardiac tumours (fibroma and teratoma) both arising from the interventricular septum and underwent surgical excision. A possible role of cardiac remodeling in myocardial tissue healing after extensive tissue resection in such patients is hypothesised through available experimental or limited clinical information.

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A well-demarcated mass showing different mature tissues and dilated cystic spaces lined by respiratory- and mucinous-type epithelium. No immature elements of germinal tissue noted (hematoxylin and eosin stained, 10x).
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Fig6: A well-demarcated mass showing different mature tissues and dilated cystic spaces lined by respiratory- and mucinous-type epithelium. No immature elements of germinal tissue noted (hematoxylin and eosin stained, 10x).

Mentions: The patient underwent surgical excision of the tumour under standard CPB, bicaval and aortic cannulation, aortic cross-clamping and cardioplegic arrest through the right atrial approach at moderate systemic hypothermia. A large tumour mass (4×3 cm) originated from the interventricular septum and filled the ventricular cavity, adjacent to the tricuspid valve (Figure 5). With careful dissection, the tumour was fully resected without injury to the tricuspid valve or creating defect. The patient was weaned from the CPB and was stable throughout. The histopathology confirmed teratoma featuring a derivative from all three germ layers. There were focal cystic, degenerative and micro-calcific changes seen in the well demarcated excised mass with a thick fibrous capsule. The dilated cystic spaces were lined by respiratory- and mucinous-type epithelium (Figure 6). Postoperative course was uneventful. The follow up at 6 months was unremarkable except the AFP is down to 58 IU/ml.Figure 5


Large cardiac fibroma and teratoma in children- case reports.

Jha NK, Kiraly L, Tamas C, Talo H, Khan MD, El Badaoui H, Jain A, Hammad A - J Cardiothorac Surg (2015)

A well-demarcated mass showing different mature tissues and dilated cystic spaces lined by respiratory- and mucinous-type epithelium. No immature elements of germinal tissue noted (hematoxylin and eosin stained, 10x).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4373309&req=5

Fig6: A well-demarcated mass showing different mature tissues and dilated cystic spaces lined by respiratory- and mucinous-type epithelium. No immature elements of germinal tissue noted (hematoxylin and eosin stained, 10x).
Mentions: The patient underwent surgical excision of the tumour under standard CPB, bicaval and aortic cannulation, aortic cross-clamping and cardioplegic arrest through the right atrial approach at moderate systemic hypothermia. A large tumour mass (4×3 cm) originated from the interventricular septum and filled the ventricular cavity, adjacent to the tricuspid valve (Figure 5). With careful dissection, the tumour was fully resected without injury to the tricuspid valve or creating defect. The patient was weaned from the CPB and was stable throughout. The histopathology confirmed teratoma featuring a derivative from all three germ layers. There were focal cystic, degenerative and micro-calcific changes seen in the well demarcated excised mass with a thick fibrous capsule. The dilated cystic spaces were lined by respiratory- and mucinous-type epithelium (Figure 6). Postoperative course was uneventful. The follow up at 6 months was unremarkable except the AFP is down to 58 IU/ml.Figure 5

Bottom Line: There are several consecutive series published in the last decade on cardiac neoplasms.Therefore, this is not only an effort to contribute to the existing literature for better understanding and management of similar patients but also to highlight the importance of early detection either by prenatal imaging or careful evaluation of differential diagnosis of common symptoms.We herein, describe two infants with large cardiac tumours (fibroma and teratoma) both arising from the interventricular septum and underwent surgical excision.

View Article: PubMed Central - PubMed

Affiliation: Division of Paediatric Cardiac Surgery, Sheikh Khalifa Medical City (managed by Cleveland Clinic), PO Box-51900, Karamah Street, Abu Dhabi, United Arab Emirates. njha@skmc.ae.

ABSTRACT
Primary cardiac tumours in paediatric population are an unusual occurrence. Although, majority of such tumours are benign (90%), the frequency and type of cardiac tumours in this age group is different from the adult population. There are several consecutive series published in the last decade on cardiac neoplasms. Therefore, this is not only an effort to contribute to the existing literature for better understanding and management of similar patients but also to highlight the importance of early detection either by prenatal imaging or careful evaluation of differential diagnosis of common symptoms. We herein, describe two infants with large cardiac tumours (fibroma and teratoma) both arising from the interventricular septum and underwent surgical excision. A possible role of cardiac remodeling in myocardial tissue healing after extensive tissue resection in such patients is hypothesised through available experimental or limited clinical information.

Show MeSH
Related in: MedlinePlus