Journal of Pediatric Cardiology and Cardiac Surgery

Down syndrome and cardiac tumor occurring in the same patient is a rare condition. Patients with primary cardiac tumors face an uncertain treatment strategy that ranges from conservative management to aggressive surgical intervention. We report here the case of cardiac fibroma in a newborn with Down syndrome, and we discuss the most appropriate way of making a diagnosis and treatment in patients with cardiac masses. In this case, although the cardiac mass was large, the patient was asymptomatic. We tried to make a definitive diagnosis through the use of magnetic resonance imaging but failed to reveal the diagnosis. Although histologic and immunohistochemical examinations are useful to get a correct diagnosis of the type of tumor and its malignancy, clinicians should keep in mind that open surgical approach can have serious implications that require consideration. Conservative management of cardiac masses in a newborn who is strictly asymptomatic seems to be an acceptable strategy when the risks of surgical intervention outweigh the benefits.