A Report of Three Cases of Cardiac Tumors in Children with Favorable Courses

Abstract

We describe a patient who was found to have a large benign mesenchymal tumor of the right ventricular wall and right pulmonary artery stenosis at the age of 20 months. Following biopsy of the tumor, the patient’s respiratory distress improved gradually and cardiac catheterization at the age of ten years showed normal intracardiac pressures and disappearance of right pulmonary artery stenosis. He remained asymptomatic at age 20. Possible factors for the spontaneous regression of the tumor are discussed.

Case Details

Personal Characteristics

Three-day-old female, m. T. B., was admitted to the hospital in july 1965 for cyanosis and heart murmur.

Clinical Characteristics

Physical examination showed a slight degree of respiratory distress. Auscultation revealed a systolic murmur of weak intensity graded ii/IV along the left side of the sternum. Electrocardiogram showed a marked left ventricular hypertrophy with alterations of the repolarization phase. Cardiopulmonary x-rays revealed extreme cardiomegaly.

Remission Characteristics

Six years later, the patients were still alive, and improvements of both the electrocardiogram and of the cardiopulmonary x-ray pictures were noted. A second cardiac catheterization showed an almost complete disappearance of the pathological images.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Cardiac catheterization and angiocardiography revealed the presence of a very large tumor infiltrating a large part of the heart. During the operation, surgical resection proved to be impossible on account of the extent of the lesion.

Additional Notes

The patient left the hospital in good condition. She was rehospitalized 6 years later for neurological symptoms: psychomotor retardation and epilepsy. A diagnosis of tuberous sclerosis was made. From the cardiac point of view, the persistence of a slight precordial systolic murmur was reported. On the other hand, the cardiopulmonary x-rays showed only a slight cardiomegaly. At the same time, the left ventricular potentials were notably diminished as compared to the curve obtained at admission. Another cardiac catheterization with angiocardiography showed no tumoral image. The cardiac cavities were no longer displaced and had a normal morphology except for the left ventricle which appeared slightly deformed. The given hemodynamic measurements were normal.