Tumors and thrombi

Abstract

Most cardiac tumors in pediatric patients are histologically benign. Usually they are solid and nonmobile. The 2 most frequently encountered are rhabdomyoma, which are associated with tuberous sclerosis, and fibroma. Tumors in children are usually intramural, appearing echocardiographically as a localized bulge or excessive thickening within the cardiac walls. Fibromas appear as a large mass of echoes frequently protruding and/or encroaching upon cardiac structures (fig. 14.1). Sometimes, as with rhabdomyoma, multiple tumor-nodules may be found involving either the ventricular walls (fig. 14.2), cardiac valves or papillary muscles (fig. 14.3). This may lead to valvular dysfunction, which is readily apparent or echocardiographic viewing. As rhabdomyomas have a natural tendency to regress [1], ultrasonic appraisal should be repeated regularly certainly if valvular dysfunction was initially documented (fig. 14.4 a-d). In addition, echocardiographic assessment should continue after surgical removal of tumors, as some have a natural tendency to recur.