New Onset Cardiac Murmur and Exertional Dyspnea in an Apparently Healthy Child: A Rare Localization of Obstructive Myxoma in the Right Ventricle Outflow Tract without Pulmonary Embolization—A Case Report and Literature Review

Carolina D’Anna (), Alberto Villani, Antonio Ammirati, Paola Francalanci, Laura Ragni, Giulia Cecconi, Aurelio Secinaro, Marcello Chinali, Antonella Santilli, Paolo Guccione, Lorenzo Galletti and Gianluca Brancaccio
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Carolina D’Anna: Department of Cardiac Surgery, Cardiology and Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Alberto Villani: Department of Emergency, Admission and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Antonio Ammirati: Department of Emergency, Admission and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Paola Francalanci: Department of Pathological Anatomy, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Laura Ragni: Department of Cardiac Surgery, Cardiology and Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Giulia Cecconi: Department of Cardiac Surgery, Cardiology and Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Aurelio Secinaro: Advanced Cardiovascular Imaging Unit, Department of Imaging, IRCCS Bambino Gesù Children’s Hospital, 00165 Rome, Italy
Marcello Chinali: Department of Cardiac Surgery, Cardiology and Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Antonella Santilli: Department of Cardiac Surgery, Cardiology and Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Paolo Guccione: Department of Cardiac Surgery, Cardiology and Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Lorenzo Galletti: Department of Cardiac Surgery, Cardiology and Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
Gianluca Brancaccio: Department of Cardiac Surgery, Cardiology and Heart and Lung Transplant, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy

IJERPH, 2022, vol. 19, issue 19, 1-9

Abstract: Myxomas are slowly growing benign neoplasms which are rare in children. Up to 80% can be located in the left atrium and generate symptoms such as embolism, cardiac failure, fever and weight loss. Rarely, myxomas can be detected in the right ventricle outflow tract, causing arrhythmias, pulmonary emboli and sudden death. We report the case of a 13-year-old healthy child brought to the Emergency Department (ED) of the Children’s Hospital Bambino Gesù, Rome, for recent dyspnea, chest pain on exertion and new onset cardiac murmur. Patient underwent medical examination and echocardiogram with the finding of a rounded and lobulated voluminous mass in the right ventricle outflow tract (RVOT) which caused severe obstruction. The contrast computed tomography (CT) scan confirmed the presence of a heterogeneously enhancing soft-tissue mass occupying the RVOT with no evidence of pulmonary embolization. The mass was surgically excised, and the pathologic examination confirmed our suspicion of myxoma. Our experience suggests that myxoma can have mild clinical symptoms, the presentation may be non-specific, and diagnosis can be a challenge Careful examination and a diagnostic imaging workup, primarily with the transthoracic echocardiogram, are needful to make a rapid differential diagnosis and to better manage surgical treatment and follow-up.

Keywords: tumor; heart; children; right ventricle; echocardiogram; embolism; Carney complex (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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