Image in Cardiology
Infant heart tumour
Tumor cardíaco em lactente
Pedro Epifânio
, Maria Emanuel Amaral, Natália Noronha, Andreia Francisco, Dina Rodrigues, António Pires, Eduardo Castela
Corresponding author
Hospital Pediátrico de Coimbra, Serviço de Cardiologia Pediátrica, Coimbra, Portugal
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"tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "91" "paginaFinal" => "92" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Dissecção da aorta iatrogénica – segue a imagem!" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2988 "Ancho" => 3000 "Tamanyo" => 629532 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Thin (3 mm) maximal intensity projection reconstructions in coronal (first row) and transverse planes (second and third rows) of the multidetector chest CT scan performed on the first day (Panels A, B, C), on the second day (panels D, E, F) and one week later (Panels G, H, I), showing how the ascending aortic dissection and RCA occlusion and reperfusion evolved.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Catarina Vieira, Nuno Bettencourt, Nuno Ferreira, Mónica Carvalho, Vasco Gama" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Catarina" "apellidos" => "Vieira" ] 1 => array:2 [ "nombre" => "Nuno" "apellidos" => "Bettencourt" ] 2 => array:2 [ "nombre" => "Nuno" "apellidos" => "Ferreira" ] 3 => array:2 [ "nombre" => "Mónica" "apellidos" => "Carvalho" ] 4 => array:2 [ "nombre" => "Vasco" "apellidos" => "Gama" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204918300163?idApp=UINPBA00004E" "url" => "/21742049/0000003700000001/v1_201802220457/S2174204918300163/v1_201802220457/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Infant heart tumour" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "93" "paginaFinal" => "94" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Pedro Epifânio, Maria Emanuel Amaral, Natália Noronha, Andreia Francisco, Dina Rodrigues, António Pires, Eduardo Castela" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Pedro" "apellidos" => "Epifânio" "email" => array:1 [ 0 => "p.pires.epifanio@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Maria Emanuel" "apellidos" => "Amaral" ] 2 => array:2 [ "nombre" => "Natália" "apellidos" => "Noronha" ] 3 => array:2 [ "nombre" => "Andreia" "apellidos" => "Francisco" ] 4 => array:2 [ "nombre" => "Dina" "apellidos" => "Rodrigues" ] 5 => array:2 [ "nombre" => "António" "apellidos" => "Pires" ] 6 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Castela" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Hospital Pediátrico de Coimbra, Serviço de Cardiologia Pediátrica, Coimbra, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Tumor cardíaco em lactente" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1053 "Ancho" => 1133 "Tamanyo" => 89537 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray showing an abnormal left-sided cardiac silhouette.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a two-month-old, previously healthy female infant seen in the emergency department with a lower respiratory tract infection. The chest X-ray showed bilateral interstitial peribronchial thickening and an abnormally shaped cardiac silhouette (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>), for which she was referred for pediatric cardiology assessment.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The echocardiogram showed a 25×14 mm ovoid, heterogeneous echogenic intramyocardial mass localized to the apical LV lateral wall and also involving the base of the anterolateral papillary muscle. No extension of the mass was evident beyond the myocardium, and there was also no obstruction of the left ventricle inflow or outflow tract or mitral regurgitation (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>). The electrocardiogram showed abnormal positive T wave in V1 and negative T waves in V2 to V6 and in leads I, II and aVL. No other abnormal findings were found.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">In order to better characterize the mass, cardiac magnetic resonance imaging (CMRI) was performed (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>) which confirmed the presence of an apical intramyocardial heterogeneous mass measuring 30×14 mm extending to the base of the anterolateral papillary muscle, with clear hypoperfusion on first-pass perfusion (FPP), surrounded by a rim of normally perfused myocardium, isointense on T1-weighted turbo spin-echo imaging (TSE) and slightly hyperintense on T2 TSE. Myocardial delayed enhancement (MDE) showed very strong late gadolinium enhancement. The tissue characteristics were strongly suggestive of a cardiac fibroma.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Based on these findings and the fact that there were no clinical symptoms or signs of cardiac compromise we opted for a conservative approach.</p><p id="par0120" class="elsevierStylePara elsevierViewall">At the age of 9 months, follow-up echocardiogram showed that the mass measured 28×19 mm in diameter. The infant remains asymptomatic with normal left ventricle function, no outflow tract obstruction and no mitral valve regurgitation.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-10-31" "fechaAceptado" => "2017-02-11" "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1053 "Ancho" => 1133 "Tamanyo" => 89537 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray showing an abnormal left-sided cardiac silhouette.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1052 "Ancho" => 2000 "Tamanyo" => 156873 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram showing an intramyocardial left ventricle cardiac mass (*) involving the base of the anterolateral papillary muscle. A – apical 4-chamber view; B – parasternal short axis view; C – parasternal long axis view.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 661 "Ancho" => 2000 "Tamanyo" => 97273 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Cardiac magnetic resonance imaging in 4-chamber view showing an apical intramyocardial heterogeneous mass (*). A – First-pass perfusion; B – Myocardial delayed enhancement.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003700000001/v1_201802220457/S2174204918300175/v1_201802220457/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003700000001/v1_201802220457/S2174204918300175/v1_201802220457/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204918300175?idApp=UINPBA00004E" ]
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