Mitral Annular Tumors: Report of Two Cases in Childhood

Cardiac Tumors in Pediatric Patients: A Systematic Review

This systematic review sought to investigate the current evidence regarding surgical management of primary cardiac tumors in children and adolescents. Twenty-eight studies were deemed eligible, reporting on 745 pediatric patients. Rhabdomyoma was the most prevalent histologic type and echocardiography was the most common diagnostic tool. Cumulative 30-day mortality rate was 6.7%. Rhabdomyomas and teratomas had the highest 30-day mortality. The higher percentage of tumor relapse was noted for myxoma and teratoma. Although cardiac tumors are rare, their atypical clinical presentation, potential for recurrence, and the poor prognosis associated with recurrence elucidate the need for reliable diagnostic and therapeutic management.

Lymphocyte-rich capillary-cavernous hemangioma of the mitral valve: a case report and review of the literature

Valvular hemangioma incidence is extremely low. In this report, we describe a 62-year-old man who presented with mild edema of the lower limbs. An echocardiogram revealed an incidental 1.3-cm diameter mass on the anterior mitral valve leaflet for which he underwent surgical resection and mitral valve replacement. Histopathological examination showed a lymphocyte-rich capillary-cavernous hemangioma. The exuberant lymphoid stroma is unusual for hemangioma and represents an undescribed pattern of cardiac hemangioma. Including the present report, only 13 cases of mitral valve hemangioma have been reported to date. Most patients are adult. Mitral hemangioma originates in the atrial aspect of the valve and involves more commonly the anterior leaflet. The average maximum diameter of the lesion is 1.7 (S.D.=0.75) cm. Pure cavernous hemangioma is the predominant type of mitral hemangioma. Most of them are described as pedunculated or polypoid. Surgical excision appears to be curative. Recurrences have not been reported. Lymphocyte-rich cardiac hemangioma represents a peculiar type of hemangioma which should be included in the differential diagnosis of other vascular lesions.

An exceptional cause of progressive dyspnoea in a renal transplant recipient: hemangioma of the mitral valve

Primary cardiac hemangioma is a very rare benign vascular tumor, with valvular hemangiomas being even less frequent as valves are generally avascular structures. We present the first case of mitral valve hemangioma in a renal transplant recipient. Patient presented with progressive dyspnea. Transesophageal echocardiogram (TEE) demonstrated a 0.8x0.9-cm pedunculated tumor mass on the posterior leaflet of the mitral valve. Coronary angiography identified a small artery which filled from the circumflex artery and fed the tumor. The tumor was surgically removed. Histopathological examination revealed a hemangioma. The postoperative course was uneventful with stable graft function.

Incidental in vivo detection of an isolated hemangioma of the aortic valve in a man with a history of renal transplantation

Hemangiomas of the cardiac valves are exceptional. To our knowledge, only ten cases of valve hemangiomas, six in the mitral and four in the tricuspid valve, have been reported in the English literature. We describe an incidentally detected aortic valve hemangioma of a 62-year-old man with chronic, degenerative aortic valve stenosis, who underwent renal transplantation 7 years before. We believe that this is the first report of a hemangioma in this localization and the first one in association with solid organ transplantation. The review of the literature of the adult cases of valve hemangioma, including this report, revealed that the average age was 47.2 years (range, 24 to 68 years). No clear sex predominance has been noted. Patients can be asymptomatic or experience sudden death. Symptomatic patients have complaints of palpitations, dyspnea, or syncopal episodes. Histologically, these valve tumors are classified as capillary, cavernous, and mixed. Mean tumor size is 1.1 cm (range, 0.6 to 2 cm). In 50% of cases the hemangioma is an incidental finding at autopsy or in a removed valve. Valve aortic hemangioma, despite its rarity, should be considered in the differential diagnosis of vascular lesions of this cardiac valve.