Svoboda Libor, Mank Sabine, Meier Sabine, Vollroth Marcel, Kiess Alexandra, Schürer Christian
Department of Pediatric and Adolescent Medicine, University Hospital Jena, Jena, Germany.
Section of Pediatric Radiology, Department of Radiology, University Hospital Jena, Jena, Germany.
Front Pediatr. 2025 Jul 2;13:1621500. doi: 10.3389/fped.2025.1621500. eCollection 2025.
Neonatal intracardiac masses are rare and pose significant diagnostic and therapeutic challenges, particularly in differentiating thrombi from tumors.
We present the case of a preterm neonate with a right atrial mass of uncertain etiology. Multimodal imaging, including echocardiography and cardiac MRI, suggested the presence of a thrombus-consistent with thrombi being the most common type of intracavitary cardiac mass. As a result, primary anticoagulation therapy was initiated. However, after 16 days without significant change in the mass and given the high risk of embolization and the possibility of a benign tumor, surgical excision was performed. Histopathological analysis of the excised tissue could not definitively distinguish between an organized thrombus and a regressed benign neoplasm, although no malignant cells were identified.
This case highlights the diagnostic uncertainty surrounding neonatal intracardiac masses and the limitations of imaging and pathology in achieving definitive diagnosis. A multidisciplinary approach and long-term follow-up are essential, particularly when the true nature of the mass remains unclear.
新生儿心脏内肿块罕见，在诊断和治疗方面带来重大挑战，尤其是在区分血栓与肿瘤方面。
我们报告一例病因不明的早产新生儿右心房肿块病例。包括超声心动图和心脏磁共振成像在内的多模态成像提示存在血栓——血栓是心腔内最常见的心脏肿块类型。因此，开始了初步抗凝治疗。然而，16天后肿块无明显变化，鉴于栓塞风险高以及存在良性肿瘤的可能性，进行了手术切除。尽管未发现恶性细胞，但对切除组织的组织病理学分析无法明确区分机化血栓和消退的良性肿瘤。
本病例凸显了新生儿心脏内肿块诊断的不确定性以及成像和病理学在明确诊断方面的局限性。多学科方法和长期随访至关重要，尤其是当肿块的真实性质仍不清楚时。
