My daughter has tumors in the heart. What are the chances of survival?

Hello,

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Firstly, there is a diagnostic dilemma. The reports you have uploaded (attachment removed to protect the patient's identity) are fine. But, you should upload the echo reports and the fluid investigations as well. Now, considering the pericardial effusion with multiple cardiac tumors, the possibilities of a rhabdomyoma or a teratoma are high. However, an effusion is not common with rhabdomyoma. It is possible to have some other cause for the effusion and it can also be as a result of a heart failure. Both of these are benign tumors. However, at this stage, we cannot rule out a malignancy. The next thing to be done is that she should undergo a cardiac MRI for further characterization of the lesions, which will give us a diagnosis and also resolve the issue of malignancy. Also, if the fluid is available, it should be tested for ADA (adenosine deaminase) and GeneXpert. She should also undergo a thyroid test. Rhabdomyomas usually occurs in patients with tuberous sclerosis, so she should be adequately examined by the doctor for the same. A definitive treatment is the excision of these tumors surgically. So, you can discuss this with the doctor as well. Hope this helps you. Do write back in case of doubts.

Hello,

Welcome back to icliniq.com.

I have gone through the reports (attachment removed to protect patient identity). Her BP is low and her pulse rate is high probably because the pericardial effusion is compressing the heart leading to a tamponade. A pigtail insertion should be done in the pericardial cavity and the fluid should be drained, if not being done already. An aspiration of the fluid should be done every day if the pigtail is already in situ. Usually, not always, a pericardial effusion is caused by malignant tumors. But, the chances of a malignancy depends upon the picture of the tumor on an echo or other imaging like MRI or CT scan. We need multiple samples of fluid to detect the cells, as one or two can sometimes be negative. So you should request them to send the fluid every day till we have a diagnosis. Sorry to mention that the prognosis, in the case of a malignant tumor, is not very good and the survival rate is poor. But, it will also depend on the exact type of tumor and the spread of the tumor to other structures. Also, the treatment plans like surgery, chemotherapy or radiotherapy will be decided after knowing the type of tumor. So, it is important to send repeated samples for testing. Also, the other option is pericardiotomy and biopsy of the masses. So, I think making a diagnosis is an important step here. Hope this helps you. All the best.