Fibroma of the interventricular septum with bilateral obstruction of the ventricular outflow/tracts
https://doi.org/10.24835/1607-0763-855
Abstract
Heart fibroma accounts for about 5% of all primary neoplasms and is registered in children in 80% of cases. The ventricles or interventricular septum (IVS) are most often affected; in half of cases, the tumor has intracavitary growth. The clinical picture of the disease and its prognosis depend on the size and location of the tumor. The most unfavorable is the defeat of the IVS, since it causes obstruction of the output tract of one of the ventricles. Being localized in IVS, can involve a conducting system of heart, thereby increasing risk of sudden death.
A retrospective study of a case of cardiac fibroma in a child aged 4.5 months, confirmed by echocardiography, magnetic resonance imaging and successfully operated on in the Central Federal District Center of Penza, is presented. A large tumor, localized in the IVS, caused atypical obstruction of the outflow tracts of both ventricles simultaneously. In the domestic and foreign literature, hemodynamic disturbances of only one of the ventricles are described, and we did not find a single case with simultaneous obstruction of both tracts. The possibility of MRI in the diagnosis of heart tumors has been shown.
About the Authors
V. G. Karpukhin
Federal Centre for Cardiovascular Surgery
Russian Federation
Russian Federation
roentgenologist of radiology department,
6, Stasova str., Penza, 440071
T. I. Paramonova
Federal Centre for Cardiovascular Surgery
Russian Federation
Russian Federation
Cand. of Sci. (Med.), roentgenologist, chief of radiology department,
6, Stasova str., Penza, 440071
References
1. Volkolakov Ya.V., Egorov G.N., Heninya R.L. Diagnosis of primary heart tumors. Cardiology. 1987; 27 (6): 100–101. (In Russian)
2. Parmley L.F., Salley R.K., William J.P., Head 3rd G.B. The clinical spectrum of cardiac fibroma with diagnostic and surgical consideration: noninvasive imaging enhances management. Ann. Thorac. Surg. 1988; 45: 455–465. http://doi.org/10.1016/s0003-4975(98)90028-5
3. Burke A.P., Rosado-de-Christenson M., Templeton P.A., Virmani R. Cardiac fibroma: Clinicopathologic correlates and surgical treatment. J. Thorac. Cardiovasc. Surg. 1994; 108 (5): 862–870. https://pubmed.ncbi.nlm.nih.gov/7967668/
4. Henaine R., Adam E., Azarnoush K., Yashimura N., Cannesson M., Millon A. et al. Is subtotal resection of a right ventricular fibroma a valid surgical option? J. Thorac. Cardiovasc. Surg. 2009; 137 (1): e32–е34. http://doi.org/10.1016/j.jtcvs.2008.05.062.
5. Padalino M.A., Vida V.L., Boccuzzo G., Tonello M., Sarris G.E., Berggren H., et al. Surgery for primery cardiac tumors in children: early and late results in a multicenter European Congenital Heart Surgeons Association study. Circulation. 2012; 126: 22–30. http://doi.org/10.1161/CIRCULATIONAHA.111.037226
6. Petrovsky B.V., Nechaenko M.A. Tumors of the heart. Diseases of the heart and blood vessels: A guide for doctors. Ed. E.I. Chazov. M.: Medicine, 1997; 2: 382–404. (In Russian)
7. Freedom R.M., Lee K.J., McDonald C., Taylor G. Selected aspects of cardiac tumors in infancy and childhood. Pediatr. Cardiol. 2000; 21 (4): 299–316. http://doi.org/10.1007/s002460010070
8. Isaacs H. Fetal and neonatal cardiac tumors. Pediatr. Cardiol. 2004; 25: 252–273. http://doi.org/10.1007/s00246-003-0590-4
9. Burke A., Virmani R. Pediatric heart tumors. Cardiovasc. Pathol. 2008; 17: 193–198. http://doi.org/10.1016/j.carpath.2007.08.008
10. Torimitsu S., Nemoto T., Wakayama M., Okubo Y., Yokose T., Kitahara K., Ozawa T., Nakayama H., Shinozaki M., Sasai D., Ishiwatari T., Takuma K., Shibuya K. Literature survey on epidemiology and pathology of cardiac fibroma. Eur. J. Med. Res. 2012; 17: 5. http://doi.org/10.1186/2047-783X-17-5
11. McAllister H. A., Fenoglio J.J. Tumor of cardiovascular system. Atlas of tumor pathology. Armed Forces Institute Of Pathology. Washington, 1977. 12. Beghetti M., Gow R.M., Haney I., Mawson J., Williams W.G., Freedom R.M. Pediatric primary benign cardiac tumors: a 15-year review. Am. Heart J. 1997; 134 (6): 1107–1114. http://doi.org/10.1016/s0002-8703(97)70032-2
12. Grinda J.M., Mace L., Dervanian P., Neveux J.Y. Obstructive right ventricular cardiac fibroma in an adult. Eur. J. CardioThorac. Surg. 1998; 13: 319–321. http://doi.org/10.1016/s1010-7940(98)00003-7
13. Chen Y., Sun J, Chen W., Peng Y., An Q. Thirddegree atriovenricular block in an adult with a giant cardiac fibroma. Circulation. 2013; 127: 522–524. http://doi.org/10.1161/CIRCULATIONAHA.112.131417.
14. Bockeria L.A., Malashenkov A.I., Kavsadze V.E., Serov R.A. Cardio-oncology. M.: Publishing house NTsSSKh im. A.N.Bakuleva RAMS, 2003. 250 p. (In Russian)
15. Belenkov Yu.N., Sinitsin V.E., Ternovoy S.K. Magnetic resonance imaging of the heart and blood vessels. Moscow: Vidar, 1997. 144 p. (In Russian)
16. Telen M., Erbel R., Kreitner K-F., Barkhausen J. Radiation methods for diagnosing heart disease. M.: MEDpressinform, 2011. 408 p. (In Russian)
17. Bogaert J., Dymarkowski S., Taylor A.M. Clinical Cardiac MRI. Springer, 2005. 549 p.
18. Buckley O., Madan R., Kwong R., Rybicki F.J., Hunsaker A. Cardiac Masses, Part 1: Imaging Strategies and Technical Consideration. Am. J. Roentgenol. 2011; 197:837–841. http://doi.org/10.2214/AJR.10.7260
19. Buckley O., Madan R., Kwong R., Rybicki F.J., Hunsaker A. Cardiac Masses, Part 2: Key Imaging Features for Diagnosis and Surgical Planning. Am. J. Roentgenol. 2011; 197: 842–851. http://doi.org/10.2214/AJR.11.6903
20. Burke A., Virmani R. Atlas of Tumor Pathology. Tumors of the Heart and Great Vessels. Armed Forces Institute of Pathology. 1996. 231 p.
21. Pittman S., Sethi P., Flavell R.R., Pampaloni M.H. Cardiac Fibroma. An Uncommon Cause of a Fixed Defect on Myocardial Perfusion Imaging. Clin. Nucl. Med. 2018; 43 (2): e56–e58. http://doi.org/10.1097/RLU.0000000000001924
22. Picarelli D., Leone R., Surraco J.L., Fernandez N., Antelo M., Grela C., Speyer J., Bianchi D., Rios M., Chiesa P. Complete Resection of a Right-Sided Interventricular Septal Fibroma. Wld J. Pediatr. Congenit. Heart Surg. 2018; 9 (2): 242–243. http://doi.org/10.1177/2150135117747830
23. Zheng X.J., Song B. Left ventricle primary cardiac fibroma in an adult: A case report. Oncol. Lett. 2018; 16 (4): 5463–5465. http://doi.org/10.3892/ol.2018.9260
24. Xu Z.H., Wu Q.Y., Li H.Y., Xue H., Zhang M.K., Jin Y.Q. Surgical Treatment of Large Left Ventricular Fibroma in Children. Chin. Med. J. (Engl.). 2017; 130 (14): 1737– 1738. http://doi.org/10.4103/0366-6999.209901
25. Jones J.P., Ramcharan T., Chaudhari M., Bhole V., Mcleod K., Sadagopan S., Uzun O., Parry A., Till J., McMahon C.J., Stuart A.G., Walsh M.A. Ventricular fibromas in children, arrhythmia risk, and outcomes: A multicenter study. Heart Rhythm. 2018; 15 (10): 1507–1512. http://doi.org/10.1016/j.hrthm.2018.06.018
Review
For citations:
Karpukhin V.G., Paramonova T.I. Fibroma of the interventricular septum with bilateral obstruction of the ventricular outflow/tracts. Medical Visualization. 2021;25(1):140-146. (In Russ.) https://doi.org/10.24835/1607-0763-855
Views:
938
Email this article 