RP13.INTRACARDIAC PEDIATRIC TUMOURS:AN INSTITUTIONAL EXPERIENCE

Pediatric cardiac neoplasm are extremely rare with 0.0017-0.28 prevalence in most autopsy series,90% of the primary neoplasm are benign with secondary malignant neoplasm being 10-20 times more prevalent than the primary malignant .

Material and methods: A retrospective descriptive study of all paediatric cardiac neoplasm of 10 years, data was collected from institute data base.

Results : 19 patients were diagnosed with pediatric cardiac neoplasm ,of the 19 patients9(47.5%)were infants with male preponderance (68.42)across pediatric age group.52.6% were rhabdomyomas followed by myxoma(31.6%).2 cases(11%) were primary malignant neoplasm,36% cases presented with murmur and respiratory distress(31.5%).Most commonly involved chamber was RV(8 patients)in rhabdomyomas and left atrium(LA) in myxomas with 265 cases having multiple chamber involvement.31.5%patients received curative resection and 10 % received palliative resection.In our study we did not encounter any in hospital mortality.The mean length of hospital stay was 7.31 days,1 patient had recurrence at 5 year which was re operated.

Discussion:In our series ,the 19 pediatric patients were diagnosed with intracardiac tumours .The most common primary cardiac neoplasm in infants and children is rhabdomyoma .We also found distribution of tumour types similar to that published by other investigator with 52.6% of patients presenting with rhabdomyoma and 31.6% presenting with myxoma ,the second most common tumour in our series.Malignant cardiac or mediastinal tumours are extremely rare in the pediatric age group .During the study period we had only one case of secondary malignant which was a direct extension of hepatoblastoma into RA .Presentation of pediatric cardiac tumours is varied widely from being asymptomatic and life threatening cardiac events.In our series only 10.52% patients were symptomatic and incidentally diagnosed ,whereas 36% cases had cardiac murmurs and 31.5% cases presented with respiratory distress ,only 3 patients of rhabdomyoma were taken up for surgery and excision ,debunking for performed in view of symptoms .In our series all patients diagnosed with myxoma underwent surgical resection ,Debulking with excision of tricuspid valves done for one case of rhabdomyoma.As for the secondary malignancy case ,the surgery was abandoned in view of extensive nmetastasis and patients was referred for palliative adjuvant therapy ,The operative results for patients with malignant tumour however are poor.

Conclusion:Rhabdomyomas are most common primary pediatric neoplasm followed by myxomas.Overall prognosis is good owing to primary benign nature ,however the malignant variants have worst outcomes.surgical resection is indicated in symptomatic patients and clinical outcomes are excellent with very low recurrence rate.

Aakash Joshi (1), Chirag Doshi (2), (1) N/A, India, (2) N/A, Ahmedabad, India

Aakash Joshi

Poster Presenter

I am Dr Joshi Aakash Dinesh , presently working in Sree Chithra tirunal institute of medical science ,Kerala which is the only institute of national importance,

 I have been a keen enthusiast for Cardiac surgery , 

  I have been also working with TSRA ,thoracic surgery resident association - global ,and Presently appointed as the Deputy Chair .

Specialties: Multi-Specialty