在儿科人群中，原发性心脏和心包肿瘤较为罕见，可包括良性和恶性病变。肌纤维瘤、畸胎瘤、纤维瘤和血管瘤是最常见的良性肿瘤。最常见的原发性心脏恶性肿瘤是软组织肉瘤，包括未分化肉瘤、横纹肌肉瘤和纤维肉瘤。然而，转移性病变比原发性心脏肿瘤更常见。原发性心脏和心包肿瘤的儿童可能表现为非特异性心血管症状，临床表现可能与更常见的非肿瘤性心脏疾病相似。最近，通过非侵入性心脏成像技术改善了心脏肿瘤的诊断。超声心动图通常是首选的评估方式。心脏磁共振和CT用于组织特征化以及评估肿瘤的大小、范围和生理影响。原发性心脏肿瘤的各种成像表现可以通过其潜在的异常性质来解释。这些病变的治疗方式各不相同，从保守治疗，如肌纤维瘤的自发消退，到手术切除，特别是对伴发心力衰竭的患者。通过充分的成像技术和对肿瘤病理基础的认识，通常可以区分良性和恶性肿瘤，这对于适当和及时的治疗有很大影响。©RSNA，2023本文的问题可以通过在线学习中心获得。

Primary cardiac and pericardial neoplasms are rare in the pediatric population and can include both benign and malignant lesions. Rhabdomyomas, teratomas, fibromas, and hemangiomas are the most common benign tumors. The most common primary cardiac malignancies are soft-tissue sarcomas, including undifferentiated sarcomas, rhabdomyosarcomas, and fibrosarcomas. However, metastatic lesions are more common than primary cardiac neoplasms. Children with primary cardiac and pericardial tumors may present with nonspecific cardiovascular symptoms, and their clinical presentation may mimic that of more common nonneoplastic cardiac disease. The diagnosis of cardiac tumors has recently been facilitated using noninvasive cardiac imaging. Echocardiography is generally the first-line modality for evaluation. Cardiac MRI and CT are used for tissue characterization and evaluation of tumor size, extension, and physiologic effect. The varied imaging appearances of primary cardiac neoplasms can be explained by their underlying abnormality. Treatment of these lesions varies from conservative management, with spontaneous regression of some lesions such as rhabdomyomas, to surgical resection, particularly in patients with associated heart failure. With adequate imaging techniques and knowledge of the pathologic basis of the neoplasm, it is often possible to differentiate benign from malignant tumors, which can greatly affect adequate and timely treatment. ©RSNA, 2023 Quiz questions for this article are available through the Online Learning Center.