A rare case of pediatric cardiac fibroma arising from the pulmonary valve and right ventricular outflow tract presenting with obstructive hemodynamics

Abstract

Primary cardiac tumors in the pediatric population are rare, and reports of cardiac fibromas diagnosed during childhood are limited. We report a pediatric case of cardiac fibroma attached to the right ventricular outflow tract (RVOT) and pulmonary valve that presented with RVOT obstruction in a 15-month-old boy who was referred for evaluation of a heart murmur. Echocardiography revealed a mobile 10-mm mass attached to the pulmonary valve that caused RVOT obstruction and elevated right ventricular pressure. Because of the risk of embolization and hemodynamic significance, surgical excision was performed. A pathological examination confirmed the diagnosis of cardiac fibroma. Although rare, pediatric cardiac tumors can cause serious complications such as embolism and arrhythmias, thus highlighting the importance of careful auscultation, detailed imaging evaluation, and appropriate surgical decision-making.

Learning objective

Pediatric cardiac fibromas are rare and frequently asymptomatic; however, depending on their location and mobility, they may pose a significant risk of right ventricular outflow tract obstruction and embolic events. Careful cardiac auscultation, followed by timely echocardiographic assessment, is essential for early detection. Surgical intervention should be considered on the basis of hemodynamic impact rather than tumor size alone.