[Heart tumors in children. Report of 3 cases with favorable spontaneous courses]

Abstract

During a 14-year period, 8 cases of primary heart tumours were observed at Sainte-Justine Hospital. Three of these patients had a favourable course without any surgical treatment. The age of these patients was respectively 3 days, 7 weeks and 6 1/2 years. In what concerns the first two patients, the clinical and paraclinical pictures were suggestive of heart disease from the onset. Catheterization and angiocardiography confirmed the presence of a tumour deforming both ventricular cavities. In these two cases, an attempt at surgical resection proved to be impossible in view of the extent of the lesion. Biopsy demonstrated a rhabdomyoma in one of the patients and a diffuse fibroma in the other. Six and four years later, the patients were still alive, and an improvement of both the electrocardiogram and of the cardio-pulmonary X-ray pictures were noted. A second cardiac catheterization showed an almost complete disappearance of the pathological pictures. In what concerns the third patient, he was a 6-year old child with a classical Bourneville's tuberous sclerosis with a localized tumour at the junction of the superior vena cava and the right atrium. Three years later a control catheterization showed the tumour to have remained unchanged. Two conclusions might be drawn from these cases: 1 a surgical operation, although always indicated, should never entail a desperate attempt at tumour removal; 2 the prognosis should never be considered as lethal from the start.