| Objective To summarize and analyze the clinical data of children with cardiac tumors(CTs),in order to provide the guiding evidence for the diagnosis and treatments of this disease.Methods We collected the data of 53 children with CTs diagnosed and treated in our hospital from Jan 1981 to Dec 2016.Summarizing the types,growth characteristics and clinical manifestations of CTs.To assess the value of ultrasonic cardiogram(UCG)and magnetic resonance imaging(MRI)in the diagnosis of the disease.According to the treatments,patients were divided into surgical treatment group,non-surgical treatment group and observation group.They were followed up for two months to eight years and two months.Long-term prognosis(survial or death)of different groups was analyzed.Results1.There were 53 patients with CTs,of whom 45 cases(84.9%)had benign tumors,including rhabdomyoma 23 cases(43.4%),myxoma 15 cases(28.3%),fibroma 3 cases(5.7%),lipoma 1 case(1.9%),hemangioma 1 case(1.9%),teratoma 1 case(1.9%)and cyst 1 case(1.9%).There were 8 cases(15.1%)with Malignant tumors,including Metastatic CTs(MCTs)7 cases(13.2%)and Primary CTs(MCTs)1 case(5.7%).2.The most common location of CTs was multiple atrioventricular(16/53,30.2%)and most tumors were single(33/53,62.3%).All rhabdomyomas were located in ventricular wall or interventricular septum and most of them were multiple(17/23,73.9%).Most myxomas had pedicle(14/15,93.3%)and grew in atrial(9/15,60.0%).MCTs were often located in right atrium(6/7,85.7%).3.There were 8 patients(15.1%)without symptom.27 cases(50.9%)had cardiovascular system performance,of whom heart murmur(20/27,74.1%)was the most common.15 cases(28.3%)had respiratory system performance and 15 cases(28.3%)had nervous system performance.There was no specific performance in chest X-ray and electrocardiogram.4.Among the 52 patients(98.1%)performed UCG,there were 36 cases(69.2%)with certain tumor types,7 cases(13.5%)with MCTs and 9 cases(17.3%)with cardiac space-occupying lesions.13 patients(24.5%)were performed MRI,of whom all cases had clear tumor nature and 9 cases(69.2%)had certain tumor types.5.There were 16 cases(30.2%)in surgical treatment group,of which 1 case(6.3%)died during long-term followed-up.Complete resection(13/16,81.3%)or partial resection(3/16,18.7%)had no effect on long-term prognosis(P = 1.000).There were 17 cases(32.1%)in non-surgical treatment group.The mortality of patients given up surgery was 55.6%(5/9),higher than that of the surgical treatment group significantly(P=0.012).There were 20 cases(37.7%)in observation group,of which all cases had rhabdomyoma and 15 patients who had been followed survived.ConclusionThe majority of pediatric CTs are benign and rhabdomyoma is the most common.Clinical manifestations are multiple and nonspecific.UCG is the primary modality for initial evaluation of CTs.MRI can identify the nature of tumors and define the common types of CTs such as rhabdomyoma,fibroma and so on as a supplementary method.Histopathologic examination remains the diagnostic gold standard in CTs.Therapy strategies of pediatric CTs should be individualised.When the patients with special tumor types(myxoma,huge fibroma,teratoma,etc),blood flow obstruction or obvious clinical manifestations,surgical resection can alleviate illness and improve prognosis effectively.Patients without surgical indications should be follow-up regularly. |
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