1
|
Sakamoto Y, Okada S, Maekawa R, Muneuchi J, Sugitani Y, Ochiai Y, Kamimura T, Joo K, Onishi Y, Kobayashi M, Kawakami T, Motoshita J, Hasegawa S. Fetal cardiac capillary hemangioma resulting in tachyarrhythmia. Echocardiography 2022; 39:1457-1461. [PMID: 36258638 DOI: 10.1111/echo.15468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/17/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
We present the case of a fetus with cardiac capillary hemangioma in the right atrial cavity. The tumor showed dramatic growth between the 28th and 32nd week of gestation and resulted in tachyarrhythmia. The patient was born at the 33 weeks of gestation weighing 2430 g via urgent cesarean section because the rapidly growing cardiac tumor caused incessant tachyarrhythmia, pericardial effusion, and fetal circulatory incompetence. Coronary angiography revealed that the right coronary artery drained into the tumor. Due to hemodynamic deterioration, the patient underwent subtotal resection of the tumor on the 2nd day after birth. Histopathological examination revealed an undifferentiated capillary hemangioma. The patient was discharged at the age of 86 days, as the tachyarrhythmia and hemodynamic incompetence had subsided; however, bradycardia and intermittent atrioventricular conduction disturbance gradually developed. Capillary hemangioma, a rare primary cardiac space-occupying tumor in children, can invade the conduction system.
Collapse
Affiliation(s)
- Yukifumi Sakamoto
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Seigo Okada
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Ryo Maekawa
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Jun Muneuchi
- Department of Pediatrics, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Yuichiro Sugitani
- Department of Pediatrics, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Yoshie Ochiai
- Department of Cardiovascular Surgery, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Tetsuro Kamimura
- Department of Pediatric Surgery, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Kunihiko Joo
- Department of Cardiovascular Surgery, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Yuji Onishi
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Masaru Kobayashi
- Department of Pediatrics, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Takeshi Kawakami
- Department of Obstetrics and Gynecology, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Junichi Motoshita
- Department of Pathology, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Shunji Hasegawa
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| |
Collapse
|
2
|
Malakan Rad E, Radmehr H, Vasei M, Rahimi Rastgoo B. Giant congenital right atrial epithelioid-capillary hemangioma with prolonged QT interval: Case report and practical surgical treatment strategy for primary cardiac tumors in children based on 25-year review of 299 cases. Echocardiography 2018; 35:1471-1481. [PMID: 30030856 DOI: 10.1111/echo.14105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 06/22/2018] [Accepted: 06/29/2018] [Indexed: 11/28/2022] Open
Abstract
Cardiac hemangioma is very rare and accounts for 2%-3% of the primary cardiac tumors. Cardiac epitheloid-capillary hemangioma has not been reported in the pediatric population so far. We report the fatal outcome of a preterm neonate with a huge congenital right atrial epitheloid-capillary hemangioma and elevated serum alpha-fetoprotein, associated with prolonged QT interval. We describe the echocardiographic, computed tomographic (CT) imaging, microscopic and immunohistochemical features of the tumor. Complete resection of the tumor was done at operation necessitating extensive reconstruction of atrial walls. Intramural infiltration of this tumor into the surrounding myocardial walls is a challenging characteristic of cardiac hemangioma. The temptation to complete resection should be avoided in the setting of extensive intramural infiltration and entrapment of the tumoral cells into atrial walls, particularly in a preterm neonate. None of the current classifications for hemangioma was inclusive of our case. Based on a concise literature review of nine published classification systems from 1996 to 2017 , we discuss the shortcomings of the current classifications for hemangioma. We also performed a 25-year-review of 299 cases of primary cardiac tumors in neonates and children, from 1993 to May 2018. We suggest a stepwise surgical treatment strategy according to the characteristics of the patient and of the tumor, based on this review. The stepwise strategy includes watchful observation, partial resection, complete resection and cardiac transplantation.
Collapse
Affiliation(s)
- Elaheh Malakan Rad
- Pediatric Cardiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Radmehr
- Pediatric Cardiac Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Vasei
- Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
3
|
Vacirca SR, Nardi P, Ferlosio A, Orlandi A, Ruvolo G. Multifocal cardiac hemangioma. J Card Surg 2018; 33:310-312. [DOI: 10.1111/jocs.13719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Sara R. Vacirca
- Cardiac Surgery Unit; Tor Vergata University Policlinic; Rome Italy
| | - Paolo Nardi
- Cardiac Surgery Unit; Tor Vergata University Policlinic; Rome Italy
| | - Amedeo Ferlosio
- Pathological Anatomy Unit; Tor Vergata University Policlinic; Rome Italy
| | - Augusto Orlandi
- Pathological Anatomy Unit; Tor Vergata University Policlinic; Rome Italy
| | - Giovanni Ruvolo
- Cardiac Surgery Unit; Tor Vergata University Policlinic; Rome Italy
| |
Collapse
|
4
|
Federici D, Marcora S, Trezzi R, Galletti L. Neonatal intrapericardial teratoma. J Card Surg 2018; 33:296-297. [DOI: 10.1111/jocs.13571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Duccio Federici
- Cardiac Surgery Unit; “Papa Giovanni XXIII ” Hospital; Bergamo Italy
| | - Simona Marcora
- Pediatric Cardiology Unit; “Papa Giovanni XXIII” Hospital; Bergamo Italy
| | - Rosangela Trezzi
- Departement of Pathology; “Papa Giovanni XXIII” Hospital; Bergamo Italy
| | - Lorenzo Galletti
- Cardiac Surgery Unit; “Papa Giovanni XXIII ” Hospital; Bergamo Italy
| |
Collapse
|