Volumineuse tumeur cardiaque révélée par un trouble du rythme ventriculaire chez un nourrisson de 18 mois

Siblings with Gorlin-Goltz syndrome associated with cardiac tumors: a case report and review of literature

Primary cardiac tumors in children are very rare and may be associated with severe arrhythmias and sudden infant death syndrome. These cardiac arrhythmias vary depending on the location and size of the tumor. Sixty-four percent of children with cardiac fibroma, the second most common benign cardiac tumor in children, have ventricular arrhythmias, affecting therapeutic management and risk profile of these children. We report on two siblings with cardiac fibromas whose clinical presentations differed depending on their locations and size of the tumors. The first child, a three-year-old girl, was diagnosed with a cardiac fibroma in the left ventricle at the age of 8 months after surviving resuscitation due to ventricular fibrillation. Secondary prophylactic implantation of an ICD was performed. On propranolol, no further malignant arrhythmias have occurred to date. The seven-month-old brother was diagnosed postnatally with a cardiac tumor adjacent to the right ventricle. A few weeks after birth, the boy had refractory supraventricular tachycardia and ventricular arrhythmia that only resolved with amiodarone. In genetic testing, Gorlin-Goltz syndrome was diagnosed in both children. Conservative pharmacological therapy is a therapeutic strategy for asymptomatic patients with cardiac fibromas. The anti-arrhythmic medication depends on the location of the tumor. Implantation of an ICD should be performed in cases of malignant arrhythmias. In rare cases, there is an association between cardiac tumors and genetic syndromes, such as Gorlin-Goltz syndrome. These should always be considered when such a tumor is diagnosed.

Giant right ventricular fibroma co-existing atrial septal defect in a 15 year old girl

The most common benign cardiac tumours are the myxomas, the rhabdomyomas, and the fibromas, with the latter 2 variants being the most common tumours encountered in children. The size and location of tumours within the heart create a variety of clinical findings, such as murmurs, chest pain, tachyarrythmias, and congestive cardiac failure. Nowadays, the tumours are usually diagnosed by echocardiography, magnetic resonance imaging and cardiac catheterization. Surgical excision is the treatment of choice if the tumour causes either arrhythmia or cavitary obstruction. In this report, we describe a giant ventricular fibroma co-existing with an atrial septal defect in a girl aged 15 years.