1
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Sasidharan A, Parambath SP, Kuriakose KM. A case report on asymptomatic ventricular hemangioma. Indian J Thorac Cardiovasc Surg 2024; 40:590-593. [PMID: 39156070 PMCID: PMC11329446 DOI: 10.1007/s12055-023-01673-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 08/20/2024] Open
Abstract
Intraventricular cardiac hemangiomas are very rare tumors that account for 5-10% of all cardiac tumors. We report a case of an asymptomatic 21-year-old young male who was incidentally detected with ventricular mass on echocardiography followed by magnetic resonance imaging. Surgical resection was done for confirmation and to avoid potential complications. Histopathology and immunohistochemical studies confirmed the diagnosis of a hemangioma of the ventricle. Subsequent regular follow-up has revealed no complications or recurrence, underscoring the favorable long-term prognosis. This case report highlights the importance of diagnostic evaluation even in asymptomatic individuals, allowing for early recognition and effective management of this rare cardiac entity.
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Affiliation(s)
- Athira Sasidharan
- Department of Pathology, KMCT Medical College, Calicut, Kerala India
| | - Sathi Puthen Parambath
- Department of Pathology, KMCT Medical College, Calicut, Kerala India
- Department of Pathology, KMCT Medical College, calicut, India
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2
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Mitsuishi A, Miura Y, Hosogi S, Tsutsui M, Kitaoka H. 3 Lobes of Extracardiac Hemangioma. JACC Case Rep 2024; 29:102406. [PMID: 39157545 PMCID: PMC11328788 DOI: 10.1016/j.jaccas.2024.102406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 08/20/2024]
Abstract
Cardiac hemangioma is a rare benign disease, and extracardiac tumors consisting of 3 lobes are exceptionally rare. Preoperative diagnosis is extremely difficult, and it is important to evaluate the disease through a multifaceted examination.
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Affiliation(s)
- Atsuyuki Mitsuishi
- Department of Cardiovascular Surgery, Kochi Medical School Hospital, Kochi, Japan
| | - Yujiro Miura
- Department of Cardiovascular Surgery, Kochi Medical School Hospital, Kochi, Japan
| | - Shingo Hosogi
- Department of Cardiology, Hosogi Hospital, Kochi, Japan
| | - Miho Tsutsui
- Department of Pathology, Kochi Medical School Hospital, Kochi, Japan
| | - Hiroaki Kitaoka
- Department of Cardiology and Geriatrics, Kochi Medical School Hospital, Kochi, Japan
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3
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Karigyo CJT, Pessoa BMS, Nicacio SP, Terwilliger E, Costa P, dos Santos PR, Ernani V, Seetharam M, Murakami AN, Batalini F. Cardiac Tumors: Review. Braz J Cardiovasc Surg 2024; 39:e20230405. [PMID: 39038269 PMCID: PMC11262154 DOI: 10.21470/1678-9741-2023-0405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/12/2024] [Indexed: 07/24/2024] Open
Abstract
Cardiac tumors are rare and encompass a variety of presentations. Clinica symptoms are usually nonspecific, but they can present as obstructive, embolic, or constitutional symptoms. Treatment options and prognosis vary highly depending on the subtype, tumor size, and location. Surgical resection is usually the first-line therapy, except for cardiac lymphomas, and provides favorable long-term prognosis in most benign tumors. Cardiac sarcomas, however, are usually diagnosed in advanced stages, and the treatment relies on a multimodal approach with chemotherapy and radiotherapy. Metastatic cardiac tumors are usually related to advanced disease and carry an overall poor prognosis.
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Affiliation(s)
- Carlos J. T. Karigyo
- Engineering Center for Circulatory Assistance, Instituto Dante
Pazzanese de Cardiologia, São Paulo, São Paulo, Brazil
- Postgraduate Program in Medicine/Technology and Intervention in
Cardiology, Universidade de São Paulo, São Paulo, São Paulo,
Brazil
| | | | | | - Emma Terwilliger
- Mayo Clinic College of Medicine and Science, Rochester, Minnesota,
United States of America
| | - Philippos Costa
- Division of Hematology and Oncology, Yale University Yale Cancer
Center, New Haven, Connecticut, United States of America
| | - Pedro Reck dos Santos
- Division of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix,
Arizona, United States of America
| | - Vinicius Ernani
- Division of Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United
States of America
| | - Mahesh Seetharam
- Division of Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United
States of America
| | | | - Felipe Batalini
- Division of Oncology, Mayo Clinic Arizona, Phoenix, Arizona, United
States of America
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4
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Kwak JH, Yang A, Jung HL, Kim HJ, Kim DS, Shim JY, Shim JW. Cardiac Evaluation before and after Oral Propranolol Treatment for Infantile Hemangiomas. J Clin Med 2024; 13:3332. [PMID: 38893043 PMCID: PMC11172932 DOI: 10.3390/jcm13113332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/26/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Most recent clinical practice guidelines addressing the management of infantile hemangiomas (IHs) recommend oral propranolol, a non-selective beta-adrenergic antagonist, as first-line treatment. However, few reports have provided continuous follow-up data regarding cardiac evaluations. Methods: Sixty-four patients diagnosed with IHs and treated with oral propranolol before 2 years of age at the Department of Pediatrics, Kangbuk Samsung Hospital (Seoul, Republic of Korea), with regular examinations between 2017 and 2021, were included. Cardiac evaluations, including electrocardiography, Holter monitoring, chest X-ray, and echocardiography, were performed. Results: Sixty-four patients with IHs successfully underwent continuous follow-up cardiac evaluations. The median age at diagnosis was 2 weeks (1 day to 34.3 weeks). The median age at treatment initiation was 13.6 weeks (2.4-87.9 weeks), the mean longitudinal diameter of hemangioma at diagnosis was 2.8 ± 2.1 cm (0.3-12.0 cm), and the mean percentage of size decrease after 1 year of oral propranolol treatment was 71.8%. None of the 64 patients experienced severe adverse side effects during propranolol treatment. There was no statistically significant differences in echocardiographic function and electrocardiographic data after treatment. Conclusions: Propranolol treatment ≥6 months was effective and safe without significant cardiac toxicity in the treatment of patients with infantile hemangiomas.
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Affiliation(s)
| | | | - Hye Lim Jung
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea; (J.H.K.); (A.Y.); (D.S.K.); (J.W.S.)
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5
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Bernal-Gallego B, Hernández-Jiménez V, Castillo L, González-Davia R, De Antonio-Antón N, Reyes-Copa G. Unexpected diagnosis: large hemangioma in the interatrial septum. J Cardiothorac Surg 2024; 19:305. [PMID: 38816838 PMCID: PMC11138022 DOI: 10.1186/s13019-024-02794-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/28/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Cardiac hemangiomas are very uncommon benign primary tumors. They are usually located preferentially in the right atrium and their location in the interatrial septum is extremely rare. CASE PRESENTATION We report the case of a 41-year-old patient who was admitted due to a stroke. The transthoracic echocardiogram revealed a large mass in the right atrium adhered to the interatrial septum. Suspecting an atrial myxoma, surgical intervention was performed confirming that the mass extended within the thickness of the interatrial septum, protruding into the right atrial cavity. The histologic report confirmed a hemangioma. CONCLUSIONS Cardiac hemangiomas are rare primary tumors and are usually misdiagnosed as other cardiac tumors. Histopathological examination is essential for a definitive diagnosis.
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Affiliation(s)
- Begoña Bernal-Gallego
- Cardiothoracic Surgery Department, Hospital Universitario de la Princesa, Calle de Diego de León, 62, Madrid, Span, 28006, Spain.
| | | | - Lidia Castillo
- Histopathology Department Hospital Universitario de la Princesa, Calle de Diego de León, 62, Madrid, 28006, Spain
| | - Rosa González-Davia
- Cardiology Department, Hospital Infanta Cristina, Av. 9 de Junio, 2, Parla, Madrid, 28981, Spain
| | - Nieves De Antonio-Antón
- Cardiothoracic Surgery Department, Hospital Universitario de la Princesa, Calle de Diego de León, 62, Madrid, Span, 28006, Spain
| | - Guillermo Reyes-Copa
- Cardiothoracic Surgery Department, Hospital Universitario de la Princesa, Calle de Diego de León, 62, Madrid, Span, 28006, Spain
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6
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Kaewboonlert N, Chunharas P, Pluthikarmpae N, Poontananggul J, Wongthep A, Pongsuwan N, Lerssuttipon U. Right ventricular outflow tract obstruction by cardiac hemangioma in asymptomatic patient. J Surg Case Rep 2024; 2024:rjae321. [PMID: 38764738 PMCID: PMC11102782 DOI: 10.1093/jscr/rjae321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/01/2024] [Indexed: 05/21/2024] Open
Abstract
Ventricular hemangiomas are rare benign tumors, pose diagnostic and therapeutic complexities. We report a case of a 52-year-old female with essential hypertension who developed a systolic ejection murmur during a hypertension clinic visit. The echocardiogram revealed a hyperechoic mass obstructing the right ventricular outflow tract, causing enlargement of the right atrium and ventricle, with a reduction in the right ventricular ejection fraction. Due to the risk of death, the patient underwent an emergency surgical resection along with tricuspid valve replacement. Postoperative recovery was uneventful, and subsequent cardiac magnetic resonance imaging showed an improvement in ejection fraction without residual tumor. This case highlights the diagnosis and therapeutic complexities of ventricular hemangiomas. With this report, we aim to provide a comprehensive review of ventricular hemangiomas and to enhance understanding of this condition for improved patient care.
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Affiliation(s)
- Naritsaret Kaewboonlert
- Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Piyapat Chunharas
- Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima 30000, Thailand
| | - Naree Pluthikarmpae
- Department of Pathology, Suranaree University of Technology Hospital, Nakhon Ratchasima 30000, Thailand
| | - Jiraphon Poontananggul
- Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Akharawat Wongthep
- Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Natthipong Pongsuwan
- Institute of Medicine, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Udomsak Lerssuttipon
- Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima 30000, Thailand
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7
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Cheaban R, Piran M, Opacic D, Gummert JF, Rojas SV. Epicardial cavernous haemangioma; A case report of a unique incidental finding. Eur Heart J Case Rep 2024; 8:ytae146. [PMID: 38660462 PMCID: PMC11042575 DOI: 10.1093/ehjcr/ytae146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/26/2024]
Abstract
Background Primary cardiac tumours are rare, accounting for only 0.002-0.03% at autopsy. Cardiac haemangiomas are benign vascular tumours and constitute for 0.28% of all primary cardiac tumours. Cavernous haemangiomas, capillary haemangiomas, and arteriovenous haemangiomas are three distinct types. Cardiac haemangiomas are often misdiagnosed as myxomas and must be differentiated from malignant angiosarcomas. Case summary We present a 44-year-old Mediterranean male patient with a cavernous haemangioma in the inferior vena cava and right atrium, detected on transthoracic echocardiography. The patient experienced palpitations and dyspnoea on exertion. Computed tomography (CT) angiography revealed a 7.5 × 6 × 5 cm mass suspected to be perfused by the distal right coronary artery. A watch-and-wait approach was suggested, leading to a cardiac magnetic resonance imaging (MRI) with contrast 6 months later. T1 mapping exhibited a prolonged relaxation time and isointensity to the myocardium. T2 mapping revealed a homogenous hyperintense mass with heterogenous late enhancement. Surgical excision was performed using a bicaval cannulation technique on cardiopulmonary bypass. Intraoperatively, no connection to the coronaries was noted. At 1 year follow-up, the patient reported restored physical resilience, with no evidence of tumour recurrence. Discussion Clinical symptoms of cardiac cavernous haemangiomas are unspecific and become evident once the tumour grows. To investigate the nature and vascular involvement of the tumour, a contrast-enhanced CT angiography or MRI can be performed. Cardiac haemangiomas are often misdiagnosed and must be differentiated from malignant angiosarcomas. Clear guidelines for the treatment of cardiac haemangiomas in adult patients are lacking. Primary cardiac tumours require thorough investigation, and surgical intervention should be tailored to the individual's case.
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Affiliation(s)
- Rayan Cheaban
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Georgstraße 11, 32545 Bad Oeynhausen, Germany
| | - Misagh Piran
- Clinic for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, University Hospital, Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Dragan Opacic
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Georgstraße 11, 32545 Bad Oeynhausen, Germany
| | - Jan F Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Georgstraße 11, 32545 Bad Oeynhausen, Germany
| | - Sebastian V Rojas
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Med. Fakultät OWL (Universität Bielefeld), Georgstraße 11, 32545 Bad Oeynhausen, Germany
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8
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Ilcheva L, Cholubek M, Loiero D, Dzemali O. Cardiac Hemangioma in the Left Ventricular Septum. Thorac Cardiovasc Surg Rep 2024; 13:e4-e7. [PMID: 38264198 PMCID: PMC10803150 DOI: 10.1055/s-0044-1778719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/03/2023] [Indexed: 01/25/2024] Open
Abstract
Background Primary cardiac tumors are an exceedingly rare benign group of tumors that may remain asymptomatic for a prolonged duration or could lead to significant clinical events. Case Presentation A 64-year-old female patient underwent echocardiography prior to elective knee surgery due to the presence of palpitations and dyspnea. This revealed the existence of a mass located on the left side of the interventricular septum, which was resected successfully. Conclusion Surgical resection represents the primary therapeutic approach for the management of cardiac hemangiomas. Failure to perform timely resection may elevate the risk of developing total atrioventricular block and experiencing sudden death.
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Affiliation(s)
- Lilly Ilcheva
- Department of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Magdalena Cholubek
- Department of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Dominik Loiero
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Omer Dzemali
- Department of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland
- Department of Cardiac Surgery, Stadtspital Zürich Triemli, Zurich, Switzerland
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9
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Galzerano D, Eltayeb A, Alamri S, Alamri S, Arbili L, Mohammed S. A Ping Pong Ball in the Left Ventricle. J Cardiothorac Vasc Anesth 2023; 37:2153-2156. [PMID: 37394386 DOI: 10.1053/j.jvca.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 06/01/2023] [Indexed: 07/04/2023]
Abstract
Diagnosing cardiac masses, especially those related to cardiac tumors, is often challenging in clinical practice. Though myxomas are the most common and well-known benign cardiac tumors, other rare and often-neglected tumors can be difficult to diagnose. In this case report, the authors describe a left ventricular cardiac mass with unique and striking imaging features.
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Affiliation(s)
- Domenico Galzerano
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Abdalla Eltayeb
- The Heart Centre, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Soaad Alamri
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Sultan Alamri
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Lana Arbili
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Shamayel Mohammed
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
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10
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Martin SJ, Maxey-Jones C, Zhou Z, Nazem A, Cherney A, Lutz CJ. Robot-Assisted Excision of a Left Ventricular Myxoma and Hemangioma. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2023; 18:506-508. [PMID: 37786985 DOI: 10.1177/15569845231199741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Left ventricular masses are rare entities that often require surgical excision when diagnosed due to the risk of embolization. We report 2 separate patients presenting with evidence of cerebral embolization both of whom were diagnosed with isolated left ventricular masses and underwent surgical excision through a robot-assisted approach. Microscopic pathology revealed a myxoma and hemangioma, respectively. Both cases demonstrate that left ventricular masses can be feasibly excised through a robot-assisted minithoracotomy approach.
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11
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Shah M, Russo LP, Haddad D, Chang J, Okere A. Cardiac Hemangioma: A Rare Tumor Presenting as Postpartum Chest Pain. Cureus 2023; 15:e44407. [PMID: 37791176 PMCID: PMC10544837 DOI: 10.7759/cureus.44407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
Pulmonary embolism, peripartum cardiomyopathy, acute myocardial infarction, aortic dissection, anxiety, and gastroesophageal reflux disease are known causes of chest pain during the peripartum period. A cardiac tumor is a rare cause of chest pain during this time period. While cardiac myxomas during pregnancy have been reported, cardiac hemangiomas are exceptionally rare. To the best of our knowledge, there are no existing case reports regarding cardiac hemangiomas in either pregnant or postpartum patients. Here, we present a 23-year-old female who presented with visual changes, headache, and midsternal pain and was subsequently found to have a cardiac hemangioma.
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Affiliation(s)
- Mihika Shah
- Anesthesiology, Mount Sinai Morningside/West, New York, USA
- Anesthesiology, Hackensack Meridian Ocean University Medical Center, Brick, USA
| | - Lori P Russo
- North American Partners in Anesthesia (NAPA), Hackensack Meridian Ocean University Medical Center, Brick, USA
| | - Daniel Haddad
- Anesthesiology, Westchester Medical Center, Valhalla, USA
| | - Joanne Chang
- Obstetrics and Gynecology, Hackensack Meridian Ocean University Medical Center, Brick, USA
| | - Arthur Okere
- Cardiology, Hackensack Meridian Ocean University Medical Center, Brick, USA
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12
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Alsaloum M, Lee C, Dudorova E, Szabolcs MJ, Shetty M, Navot B, Ravalli S. A Right Atrial Mass Discovered Postpartum: A Diagnostic Challenge. CASE (PHILADELPHIA, PA.) 2023; 7:325-330. [PMID: 37614688 PMCID: PMC10442368 DOI: 10.1016/j.case.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
•Most primary cardiac tumors are benign with a broad differential diagnosis. •Imaging helps characterize tumors, but pathology is required for final diagnosis. •Cardiac hemangiomas are rare and often misdiagnosed, requiring biopsy.
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Affiliation(s)
- Marissa Alsaloum
- Department of Medicine, NewYork-Presbyterian, Columbia University Irving Medical Center, New York, New York
| | - Charlotte Lee
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Elena Dudorova
- Department of Medicine, Norwalk Hospital-Yale University School of Medicine, New Haven, Connecticut
| | - Matthias J. Szabolcs
- Department of Pathology, Columbia University Irving Medical Center, New York, New York
| | - Mrin Shetty
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Benjamin Navot
- Department of Radiology, Columbia University Irving Medical Center, New York, New York
| | - Stefano Ravalli
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York
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13
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Kurmann R, El-Am E, Ahmad A, Abbasi MA, Mazur P, Akiki E, Anand V, Herrmann J, Casanegra AI, Young P, Crestanello J, Bois MC, Maleszewski JJ, Klarich K. Cardiac Masses Discovered by Echocardiogram; What to Do Next? STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2023; 7:100154. [PMID: 37520139 PMCID: PMC10382990 DOI: 10.1016/j.shj.2022.100154] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/06/2022] [Accepted: 12/21/2022] [Indexed: 02/12/2023]
Abstract
Cardiac tumors are rare conditions, typically diagnosed on autopsy, but with the advancement of imaging techniques they are now encountered more frequently in clinical practice. Echocardiography is often the initial method of investigation for cardiac masses and provides a quick and valuable springboard for their characterization. While some cardiac masses can be readily identified by echocardiography alone, several require incorporation of multiple data points to reach diagnostic certainty. Herein, we will provide an overview of the main clinical, diagnostic, and therapeutic characteristics of cardiac masses within the framework of their location.
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Affiliation(s)
- Reto Kurmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Edward El-Am
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ali Ahmad
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Piotr Mazur
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Elias Akiki
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Vidhu Anand
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Joerg Herrmann
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ana I. Casanegra
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Phillip Young
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Juan Crestanello
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Melanie C. Bois
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph J. Maleszewski
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kyle Klarich
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
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14
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Abdul-Rahman DG, Hajisaeed SR, Othman YN, Anwar EO, Majeed ZS, Ali RK, Muhamad HN, Qadir OO. Patient with myelodysplastic syndrome presented with recurrent pericardial effusion diagnosed as epicardial hemangioma; Case report of a rare diagnosis with rare presentation. Radiol Case Rep 2023; 18:2253-2258. [PMID: 37123036 PMCID: PMC10130068 DOI: 10.1016/j.radcr.2023.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 05/02/2023] Open
Abstract
Primary cardiac tumors are extremely rare and cardiac hemangiomas comprise less than 3% of them. Presentation of such disease with recurrent pericardial effusion is even rarer. Our patient is known case of myelodysplastic syndrome and up to our knowledge there are no reported case in which cardiac hemangioma was diagnosed in a patient with myelodysplastic syndrome. This 64 years male patient presented to our department with recurrent pericardial effusion, diagnosis was a query after extensive work he was found to suffer from a cardiac tumor based on the pulmonary artery and right ventricle. We performed surgery for him on cardiopulmonary bypass and did complete resection of the mass for him and result of biopsy showed mixed hemangioma. Recurrent pericardial effusion is most commonly a sign of a malignancy. Even with advancement of medical technology diagnoses of cardiac hemangiomas are still difficult. Treatment and definitive diagnosis is still complete surgical resection and histopathological examination.
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Affiliation(s)
| | - Shkar R. Hajisaeed
- Head of Cardiac Surgery Department, Open Heart Center, Slemany Teaching Hospital, Sulaimani, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Iraq
| | - Yad N. Othman
- Department of Thoracic and cardiovascular surgery Surgery PY3, Shar hospital, , Sulaimani DOH/KRG, Malik Mahmood Circle, Sulaimanyah, Iraq
- Corresponding author.
| | - Erfan Omer Anwar
- Cardiac surgery department, Open Heart Center, Slemany Teaching Hospital, Sulaimani, Iraq
| | - Zryan Salar Majeed
- Department of Thoracic and Cardiovascular Surgery PY4, Shar hospital, Sulaimani
| | - Razhan K. Ali
- Department of Thoracic and Cardiovascular Surgery, Shar hospital, Sulaimani DOH/KRG, Sulaimanyah, Iraq
| | - Han Nihad Muhamad
- Pathology department, University of Sulaimany, college of dentistiry, As-Sulaimaniyah, Kurdistan, Iraq
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15
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Xie T, Masroor M, Chen X, Liu F, Zhang J, Yang D, Liu C, Xiang M. Rheumatism as a cause of cardiac hemangioma: a rare case report and review of literature with special focus on etiology. BMC Cardiovasc Disord 2023; 23:203. [PMID: 37085767 PMCID: PMC10122334 DOI: 10.1186/s12872-023-03241-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/12/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Cardiac hemangioma is a very rare benign tumor of the heart which accounts for 1-2% of all primary cardiac tumors. Multiple cardiac hemangiomas are even rarer with only three cases published in the literature. Pathologically it can be divided into cavernous hemangioma, capillary hemangioma, arteriovenous hemangioma, mixed-type hemangioma, and so on. At present, the etiology of cardiac hemangioma is not completely clear. In this study, we present multiple cardiac hemangiomas located in the right atrium and discuss the new unreported possible cause (rheumatism) of cardiac hemangioma. This is the fourth case of multiple cardiac hemangiomas in the medical literature and the first time to present rheumatism as the cause of cardiac hemangioma. CASE PRESENTATION A 53-year-old man presented to the clinic with intermittent chest tightness and shortness of breath for 2 years. On echocardiography, multiple soft tissue masses in the right atrium were found. The patient had rheumatic heart disease with severe mitral stenosis and moderate tricuspid regurgitation. Two masses with a diameter of about 20 mm and 15 mm were seen in the right atrium. One mass was located on the inferior margin of the fossa ovalis and the other was adjacent to the inferior vena cava. Both masses were successfully removed surgically. The mitral valve replacement and tricuspid valve plasty were performed at the same time. The postoperative histopathology results confirmed the diagnosis of cavernous hemangioma. CONCLUSION The occurrence of multiple hemangiomas in the heart is possible, especially in the presence of rheumatism. Rheumatism is one of the possible etiologies of cardiac hemangioma. Cardiologists and cardiac surgeons should be aware of its occurrence and should consider cardiac hemangioma as a differential diagnosis especially in rheumatic heart disease patients when they present with soft tissue cardiac masses for accurate management.
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Affiliation(s)
- Ting Xie
- Department of Cardiac Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China.
| | - Matiullah Masroor
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Department of Cardiothoracic and Vascular Surgery, Amiri Medical Complex, Afshar, Kabul, Afghanistan.
| | - Xuan Chen
- International College of Nursing, Hainan Vocational University of Science and Technology, Haikou, 570311, China
| | - Fujin Liu
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Jie Zhang
- Department of Ultrasound Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Dayan Yang
- Department of Ultrasound Medicine, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
| | - Cong Liu
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Mei Xiang
- Department of Cardiac Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, China
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16
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Ranjan A, Agarwal R, Singh D. Capillary haemangioma of the tricuspid valve annulus: A rare presentation. Int J Surg Case Rep 2023; 106:108171. [PMID: 37087932 PMCID: PMC10149200 DOI: 10.1016/j.ijscr.2023.108171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE To the best of our knowledge, very few tricuspid valves (TV) haemangiomas have been reported to date in the literature due to the avascular nature of the cardiac valve. We report the case of an otherwise healthy male presented with unexplained shortness of breath who was found to have tricuspid valvular haemangioma. CASE PRESENTATION 52-year-old male who presented with progressive dyspnoea on exertion for 6 months. Echocardiography revealed an echo-dense mass attached to the heart's anterior leaflet of the tricuspid valve. A cardiac MRI suggested it as pulmonary fibroelastoma, but a surgical excision biopsy revealed it to be a capillary haemangioma. Patient symptoms improved after surgery. CLINICAL DISCUSSION Cardiac valve tumour-like haemangiomas are rare, with the involvement of the tricuspid valve even rarer. Most TV haemangiomas are detected incidentally, however, they may present with a range of symptoms. Echocardiography is the mainstay of diagnosis however definitive diagnosis is by histopathology. Surgical excision is the treatment of choice, though surgery in asymptomatic patients is still controversial. CONCLUSION Cardiac haemangiomas are rare, with the involvement of the tricuspid valve even rarer. They should undergo surgical excision due to the risks of embolism, rupture, and sudden death.
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Affiliation(s)
- Ashis Ranjan
- Department of Cardiology, Govt TD Medical College, Alappuzha, India; All India Institute of Medical Sciences, Deoghar, India.
| | - Rajat Agarwal
- All India Institute of Medical Sciences, Deoghar, India
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17
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Franzese I, Gripshi F, Fiocco A, Rauber E, Ruggiero D, Bussani R, Mazzaro E. Cardiac Vascular Hamartoma: Adult Diagnosis and Cardiac Reconstruction. Ann Thorac Surg 2023; 115:e67-e69. [PMID: 35367435 DOI: 10.1016/j.athoracsur.2022.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/09/2022] [Accepted: 03/12/2022] [Indexed: 11/18/2022]
Abstract
Cardiac hamartoma is a rare benign tumor of the heart, and the vascular type is an extremely rare histologic diagnosis. A small number of cases have previously been described in childhood. We report the case of a 63-year-old woman with an incidentally detected cardiac mass that was finally diagnosed as vascular hamartoma. Approval for publication was obtained from the patient.
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Affiliation(s)
- Ilaria Franzese
- Division of Cardiac Surgery, Hospital of Trieste, Trieste, Italy.
| | - Florida Gripshi
- Division of Cardiac Surgery, Hospital of Trieste, Trieste, Italy; Division of Cardiac Surgery, University Hospital of Parma, Parma, Italy
| | - Alessandro Fiocco
- Division of Cardiac Surgery, Hospital of Trieste, Trieste, Italy; Division of Cardiac Surgery, University of Padua, Padua, Italy
| | | | - Danilo Ruggiero
- Division of Cardiac Surgery, Hospital of Trieste, Trieste, Italy
| | - Rossana Bussani
- Institute of Pathological Anatomy, University of Trieste, Trieste, Italy
| | - Enzo Mazzaro
- Division of Cardiac Surgery, Hospital of Trieste, Trieste, Italy
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18
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A Giant Cardiac Hemangioma Encroaching on the Right Coronary Artery. Ann Thorac Surg 2023; 115:e71-e73. [PMID: 35367437 DOI: 10.1016/j.athoracsur.2022.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/19/2022] [Accepted: 03/12/2022] [Indexed: 11/23/2022]
Abstract
The cardiac hemangioma is a relatively rare cardiac tumor. It can occur in different locations in the heart. We describe a patient with a giant cardiac hemangioma encroaching on the right coronary artery who underwent a successful surgical resection. Complete resection of the tumor was achieved without damaging the function of the right coronary artery. Nonetheless, meticulous follow-up is required as recurrence is possible.
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19
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Kesieme EB, Buchan KG. Multiple Right Ventricular Haemangiomas. Cureus 2023; 15:e36570. [PMID: 37095811 PMCID: PMC10122193 DOI: 10.7759/cureus.36570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 04/26/2023] Open
Abstract
Right ventricular haemangiomas are rare benign tumours, usually solitary and commonly located in the right heart. We report a 49-year-old female who presented with four masses in the right ventricle, three arising from the right ventricular free wall and one arising from the anterior leaflet of the tricuspid valve. She subsequently underwent total excision of the tumours and an anteroinferior commissuroplasty for severe tricuspid regurgitation complicating the excision. Histology confirmed cavernous haemangioma. Solitary haemangioma of the right ventricle has been reported severally in the literature but, to the best of our knowledge, this is the first report of multiple right ventricular haemangiomas.
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Affiliation(s)
- Emeka B Kesieme
- Cardiothoracic Surgery, Aberdeen Royal Infirmary, Aberdeen, GBR
| | - Keith G Buchan
- Cardiothoracic Surgery, Aberdeen Royal Infirmary, Aberdeen, GBR
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20
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Zhang S, Xu Z, Zou C, Zhang G. Cardiac venous malformation concurrent with multiple hepatic venous malformations: A case report. Front Cardiovasc Med 2022; 9:1001996. [DOI: 10.3389/fcvm.2022.1001996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022] Open
Abstract
A 50-year-old woman who had previously undergone right radical mastectomy presented with chest tightness and shortness of breath after physical activities. A cardiac mass and multiple hepatic lesions were successively detected. We first performed hepatic puncture biopsy. Histopathologic examination confirmed that the multiple hepatic lesions were venous malformations. Based on the imaging findings and previous reports in the literature, we boldly speculated that the cardiac mass was also a venous malformation. The cardiac venous malformation was successfully resected, and the postoperative pathology confirmed our suspicion.
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21
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Sheng C, Yang C, Cheng Y, Li YM. Current status of diagnosis and treatment of primary benign cardiac tumors in children. Front Cardiovasc Med 2022; 9:947716. [PMID: 36337871 PMCID: PMC9635942 DOI: 10.3389/fcvm.2022.947716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 10/05/2022] [Indexed: 11/20/2022] Open
Abstract
Primary cardiac tumors in children are exceedingly rare overall, which benign account for most part. The onset of the disease is occult, while the clinical manifestations are non-specific-patients may be asymptomatic or show a range of obstructive, arrhythmic, embolic or systemic symptoms. The clinical presentations generally depend on the tumors’ size, localization, and pace of growth of the tumor. Moreover, the diagnosis needs comprehensive judgment based on imaging results and pathological examination. With advances in cardiac imagining and the introduction of cardiopulmonary support, the diagnosis and treatment of these rare tumors have improved the prognosis and outlook for benign tumors. To sum up the above, we sought to integrate articles from recent years for the latest comprehensive review of the clinical manifestations, imaging characteristics, clinic pathologic features and treatment of benign cardiac tumors in children to provide a broader idea for pediatricians to recognize and treat such diseases.
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22
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Multimodality Imaging of Benign Primary Cardiac Tumor. Diagnostics (Basel) 2022; 12:diagnostics12102543. [PMID: 36292232 PMCID: PMC9601182 DOI: 10.3390/diagnostics12102543] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/18/2022] [Indexed: 11/17/2022] Open
Abstract
Primary cardiac tumors (PCTs) are rare, with benign PCTs being relatively common in approximately 75% of all PCTs. Benign PCTs are usually asymptomatic, and they are found incidentally by imaging. Even if patients present with symptoms, they are usually nonspecific. Before the application of imaging modalities to the heart, our understanding of these tumors is limited to case reports and autopsy studies. The advent and improvement of various imaging technologies have enabled the non-invasive evaluation of benign PCTs. Although echocardiography is the most commonly used imaging examination, it is not the best method to describe the histological characteristics of tumors. At present, cardiac magnetic resonance (CMR) and cardiac computed tomography (CCT) are often used to assess benign PCTs providing detailed information on anatomical and tissue features. In fact, each imaging modality has its own advantages and disadvantages, multimodality imaging uses two or more imaging types to provide valuable complementary information. With the widespread use of multimodality imaging, these techniques play an indispensable role in the management of patients with benign PCTs by providing useful diagnostic and prognostic information to guide treatment. This article reviews the multimodality imaging characterizations of common benign PCTs.
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23
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Sakamoto Y, Okada S, Maekawa R, Muneuchi J, Sugitani Y, Ochiai Y, Kamimura T, Joo K, Onishi Y, Kobayashi M, Kawakami T, Motoshita J, Hasegawa S. Fetal cardiac capillary hemangioma resulting in tachyarrhythmia. Echocardiography 2022; 39:1457-1461. [PMID: 36258638 DOI: 10.1111/echo.15468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 08/17/2022] [Accepted: 09/19/2022] [Indexed: 11/30/2022] Open
Abstract
We present the case of a fetus with cardiac capillary hemangioma in the right atrial cavity. The tumor showed dramatic growth between the 28th and 32nd week of gestation and resulted in tachyarrhythmia. The patient was born at the 33 weeks of gestation weighing 2430 g via urgent cesarean section because the rapidly growing cardiac tumor caused incessant tachyarrhythmia, pericardial effusion, and fetal circulatory incompetence. Coronary angiography revealed that the right coronary artery drained into the tumor. Due to hemodynamic deterioration, the patient underwent subtotal resection of the tumor on the 2nd day after birth. Histopathological examination revealed an undifferentiated capillary hemangioma. The patient was discharged at the age of 86 days, as the tachyarrhythmia and hemodynamic incompetence had subsided; however, bradycardia and intermittent atrioventricular conduction disturbance gradually developed. Capillary hemangioma, a rare primary cardiac space-occupying tumor in children, can invade the conduction system.
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Affiliation(s)
- Yukifumi Sakamoto
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Seigo Okada
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Ryo Maekawa
- Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Jun Muneuchi
- Department of Pediatrics, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Yuichiro Sugitani
- Department of Pediatrics, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Yoshie Ochiai
- Department of Cardiovascular Surgery, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Tetsuro Kamimura
- Department of Pediatric Surgery, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Kunihiko Joo
- Department of Cardiovascular Surgery, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Yuji Onishi
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
| | - Masaru Kobayashi
- Department of Pediatrics, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Takeshi Kawakami
- Department of Obstetrics and Gynecology, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Junichi Motoshita
- Department of Pathology, Japan Community Healthcare Organization Kyusyu Hospital, Kitakyusyu, Fukuoka, Japan
| | - Shunji Hasegawa
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan
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24
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Huang S, Wang S, Tang Z, Dai Y, Song L. Case report: Right ventricular outflow tract obstruction caused by multicomponent mesenchymal tumor. Front Cardiovasc Med 2022; 9:988271. [PMID: 36176997 PMCID: PMC9513130 DOI: 10.3389/fcvm.2022.988271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
Abstract
Right ventricular outflow tract obstruction (RVOTO) is a cause of hemodynamic instability that can lead to right ventricular dysfunction. Cardiac tumors located in the right ventricle or surrounding structures can cause RVOTO. Herein, we present a rare case of a 21-year-old male with palpitations due to RVOTO caused by a cardiac multicomponent mesenchymal tumor. The tumor was localized in the right ventricular outflow tract, resulting in right side heart enlargement, tricuspid regurgitation, and RVOTO. Hence, tumor resection was performed. The patient was in a stable condition and discharged home on the 6th post-operative day. However, histopathological examination of the tumor specimen suggested a three-component mesenchymal tumor containing mucinous components, formed blood vessels, and fibrous tissue, which is like an atypical capillary hemangioma. After seven years of follow-up, the patient had no right heart enlargement, tricuspid regurgitation, and tumor recurrence. We believe surgical treatment is effective, and this case will provide a reference for clinicians to treat and evaluate the prognosis of similar three-component mesenchymal cardiac tumor cases in the future.
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Affiliation(s)
- Shengyuan Huang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shiye Wang
- Clinical Nursing Teaching and Research Section, Operation Room, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhixiang Tang
- Department of Cardiovascular Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yinghuan Dai
- Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Long Song
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Long Song
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25
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A Rare Cardiac Cavernous Hemangioma Treated with Radiotherapy. Case Rep Vasc Med 2022; 2022:5698475. [PMID: 36105488 PMCID: PMC9467735 DOI: 10.1155/2022/5698475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/16/2022] [Accepted: 08/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Although cardiac hemangiomas, as rare benign cardiac tumors, have been described in previous case reports, the role of radiation therapy in an unresectable cardiac hemangioma in adult has not been reported. We present a case report of a rare unresectable cardiac cavernous hemangioma treated with radiotherapy. Case Presentation. A 45-year-old female with new onset of coughing and worsening shortness of breath was found to have a biopsy proven cardiac cavernous hemangioma. Surgery was aborted due to excessive bleeding, and she was then treated with radiotherapy. A total dose of 30 Gy in 15 fractions was given using intensity-modulated radiation therapy (IMRT) to the mass with a modified 1 cm margin. Complete clinical symptomatic relief was achieved with reduction of the mass posttreatment. Ten-year follow-up revealed a stable, reduced hemangioma with no recurrence of symptoms. Conclusions This is a rare example of cardiac hemangioma that developed in the right ventricle and compressed several major vessels. Radiotherapy may be safely used for treatment of unresectable cardiac hemangioma.
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26
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Galrinho A. When a misfortune does not come alone. Rev Port Cardiol 2022; 41:801-802. [DOI: 10.1016/j.repc.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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27
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Arora V, Verma M, Malhi AS, Devagourou V, Arava S, Jagia P. A rare pediatric case of pedunculated cardiac hemangioma of the left ventricle. J Card Surg 2022; 37:3384-3386. [PMID: 35842809 DOI: 10.1111/jocs.16768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022]
Abstract
A 12-year-old male child with atypical chest pain and fatigue since past 3 months underwent cardiac magnetic resonance (CMR) imaging for suspicious globular mobile mass detected in the left ventricle on a transthoracic echocardiography. CMR revealed peripheral vascular blush on the first pass perfusion images with centripetal progressive intensely bright enhancement on late gadolinium-enhanced images. Further confirmation and histological diagnosis of the tumor was made through transaortic aortic resection of the mass.
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Affiliation(s)
- Vasundhara Arora
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Mansi Verma
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Amarinder S Malhi
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Velayoudam Devagourou
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Sudheer Arava
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Priya Jagia
- Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, New Delhi, India
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28
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Hamid K, Perinkulam Sathyanarayanan S, Hoerschgen K, Ali M, Yu JC. Right Atrial Thrombus Presenting as Platypnea-Orthodeoxia Secondary to Reverse Lutembacher Syndrome: A Case Report. Cureus 2022; 14:e26754. [PMID: 35836710 PMCID: PMC9275549 DOI: 10.7759/cureus.26754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 11/05/2022] Open
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29
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Thornton SW, Hoover AC, Nellis JR, Overbey DM, Andersen ND, Haney JC, Turek JW. Minimally Invasive Approach for Cardiac Hemangioma Resection in a Teenager. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2022; 17:358-360. [PMID: 35770608 DOI: 10.1177/15569845221107012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cardiac hemangiomas are a rare tumor traditionally resected by median sternotomy. We performed a minimally invasive right ventricular cardiac hemangioma resection via a left anterior mini-incision (LAMI). The procedure was without complication, and the patient was discharged on postoperative day 2. The LAMI has been used broadly by our team for operations involving the right ventricular outflow tract, as an alternative to median sternotomy. Here we show that it can also be used for the resection of a cardiac tumor.
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Affiliation(s)
| | | | - Joseph R Nellis
- Department of Surgery, 22957Duke University Hospitals, Durham, NC, USA.,Duke Congenital Heart Surgery Research & Training Laboratory, Durham, NC, USA
| | - Douglas M Overbey
- Duke Congenital Heart Surgery Research & Training Laboratory, Durham, NC, USA.,Division of Cardiothoracic Surgery, 22957Duke University Hospitals, Durham, NC, USA
| | - Nicholas D Andersen
- Duke Congenital Heart Surgery Research & Training Laboratory, Durham, NC, USA.,Division of Cardiothoracic Surgery, 22957Duke University Hospitals, Durham, NC, USA.,Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, NC, USA
| | - John C Haney
- Division of Cardiothoracic Surgery, 22957Duke University Hospitals, Durham, NC, USA
| | - Joseph W Turek
- Duke Congenital Heart Surgery Research & Training Laboratory, Durham, NC, USA.,Division of Cardiothoracic Surgery, 22957Duke University Hospitals, Durham, NC, USA.,Pediatric & Congenital Heart Center, Duke Children's Hospital, Durham, NC, USA
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30
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CH NSM, V. B, Hote MP. Rare case of Left Ventricular Hemangioma. JOURNAL OF CARDIAC CRITICAL CARE TSS 2022. [DOI: 10.1055/s-0042-1750393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
AbstractCardiac tumors are rare in occurrence. Among them, primary cardiac tumors that too hemangiomas are further rare. They usually are asymptomatic and are detected incidentally. Preoperative diagnosis may not correlate with histopathologic diagnosis. We report such a rare case of left ventricular hemangioma presented to us with vague chest discomfort, which preoperatively was suspected to be rhabdomyoma or fibroma.
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Affiliation(s)
- Naga Sai Manjusha CH
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Bharath V.
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Milind Padmakar Hote
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
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31
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Shah A, Binkovitz L, Layman AJ, Bois MC, Nguyen B. Cardiac hemangioma mimicking a neuroendocrine tumor on 68 Ga Dotatate PET/CT. J Card Surg 2022; 37:2849-2851. [PMID: 35502494 DOI: 10.1111/jocs.16578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/07/2022] [Accepted: 04/22/2022] [Indexed: 11/27/2022]
Abstract
Cardiac hemangioma is a rare, benign primary tumor characterized by endothelial proliferation. While reports of cardiac hemangiomas demonstrating 18 F FDG avidity and other forms of hemangiomas showing 68 Ga Dotatate avidity have been published, we present a rare case of primary cardiac hemangioma demonstrating 68 Ga Dotatate avidity, mimicking a primary neuroendocrine tumor.
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Affiliation(s)
- Amar Shah
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Larry Binkovitz
- Department of Radiology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Andrew J Layman
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Melanie C Bois
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Ba Nguyen
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, USA
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32
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Bayfield N, Bibo L, Wang E, Passage J. Cavernous haemangioma of anterior mitral valve leaflet: diagnostic utility of 3D echocardiography. BMJ Case Rep 2022; 15:e247352. [PMID: 35140093 PMCID: PMC8830166 DOI: 10.1136/bcr-2021-247352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 11/03/2022] Open
Abstract
Mitral valve (MV) haemangiomas are rare primary cardiac tumours which may cause progressive cardiac failure as well as sudden death. We present a case of a 44-year-old woman referred for surgical correction of symptomatic severe mitral regurgitation. Preoperative two-dimensional transthoracic and transoesophageal echocardiography (TOE) were reported as demonstrating complex bi-leaflet prolapse causing severe mitral regurgitation. The patient was listed for MV surgery. Only on preoperative CT coronary angiogram was a filling defect noted, leading to suspicion of a cardiac tumour. Prior to skin incision, three-dimensional (3D) TOE revealed a 2×3 cm mass attached to the anterior leaflet of the MV. The tumour was subsequently resected, and the MV replaced. Postoperative histopathology confirmed a large cavernous haemangioma of the anterior MV leaflet. This case highlights a rare cause of severe mitral regurgitation and demonstrates the utility of 3D TOE as an adjunctive modality in confirming the suspected diagnosis of a cardiac tumour.
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Affiliation(s)
- Nicholas Bayfield
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Liam Bibo
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Edward Wang
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jurgen Passage
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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Vu TT, Nguyen VT, Tran QT, Ngo Thi MH, Do TH, Le HS, Nguyen NT, Nguyen VT, Lam K. A case of a small-sized cavernous hemangioma in the right ventricle - an incidental finding. Radiol Case Rep 2022; 17:856-862. [PMID: 35035650 PMCID: PMC8753057 DOI: 10.1016/j.radcr.2021.12.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 11/29/2022] Open
Abstract
A cardiac cavernous hemangioma is a rare, primary, benign tumor that is usually diagnosed in young or middle-aged patients. In this article, we report the case of a 71-year-old male patient whose doctors incidentally discovered a heart tumor on his transthoracic echocardiography. Triple-phase computed tomography (CT) (pre-contrast, arterial and portal venous) missed the lesion, and magnetic resonance imaging (MRI) revealed a small, oval tumor attached to the wall of the right ventricle. The tumor was successfully removed surgically, and the patient recovered after 2 weeks. A histopathological examination resulted in the diagnosis of a benign cavernous hemangioma.
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Affiliation(s)
- Thu Thuy Vu
- Department of Diagnostic Imaging, Hospital 108, Hanoi, Vietnam
| | | | - Quang Thai Tran
- Department of Cardiac and Vascular Surgery, Hospital 108, Hanoi, Vietnam
| | | | - Thanh Hoa Do
- Department of Emergency, Hospital 108, Hanoi, Vietnam
| | - Hai Son Le
- Department of Diagnostic Imaging, Hospital 108, Hanoi, Vietnam
| | | | - Van Thuy Nguyen
- Department of Diagnostic Imaging, Hospital 108, Hanoi, Vietnam
| | - Khanh Lam
- Department of Diagnostic Imaging, Hospital 108, Hanoi, Vietnam,Corresponding author.
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Fan J, Guo L, Teng P, Dai X, Zheng Q, Wu S, Ni Y. Diagnostic mystery-a rare right ventricular cardiac hemangioma: a case report. J Cardiothorac Surg 2021; 16:362. [PMID: 34972529 PMCID: PMC8720214 DOI: 10.1186/s13019-021-01731-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiac hemangiomas are rare in all kinds of benign cardiac tumors. Although cardiac hemangiomas affect all ages and may occur anywhere within the heart, right ventricular hemangiomas are extremely uncommon. CASE PRESENTATION We report a 56-year-old woman presented with chest tightness and breath shortness for 3 months. Transthoracic echocardiography and coronary computed tomography angiography showed a mass located adjacent to the apex of the right ventricle but both failed to figure out where the mass originated from, remaining a diagnostic mystery preoperatively. The mass was removed successfully and the histopathological examination confirmed it was hemangioma. CONCLUSIONS Cardiac magnetic resonance should be the ultimate diagnostic tool of cardiac tumors. Surgical removal, associated with a low recurrence rate and long-term survival benefits, should be the first choice of therapy for cardiac hemangiomas.
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Affiliation(s)
- Jingya Fan
- Department of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Lei Guo
- Department of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Peng Teng
- Department of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Xiaoyi Dai
- Department of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Qi Zheng
- Department of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Shengjun Wu
- Department of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China
| | - Yiming Ni
- Department of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, Zhejiang, China.
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Tang M, Jian Z, Yan Y, Guo F. Right ventricular haemangioma as a rare cause of chest pain: a case report. Eur Heart J Case Rep 2021; 5:ytab477. [PMID: 35047734 PMCID: PMC8759472 DOI: 10.1093/ehjcr/ytab477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/22/2021] [Accepted: 09/27/2021] [Indexed: 11/14/2022]
Abstract
Background Cardiac haemangioma is a rare primary cardiac tumour. Most patients with cardiac haemangioma have no typical symptoms, and some may present with non-specific manifestations, such as shortness of breath, heart palpitations, or cardiac insufficiency, making it difficult to distinguish cardiac haemangioma from other diseases. We report a case of cardiac haemangioma that present with chest pain. This haemangioma was finally completely excised to relieve the patient’s symptoms and a avoid poor prognosis. Case summary A 14-year-old boy presented with an intermittent and progressive non-exertional chest pain for 2 weeks. Echocardiography showed a space-occupying mass at the right ventricular apex, which was later confirmed by computed tomography angiography and magnetic resonance imaging (MRI). The mass was successfully resected, and postoperative pathology confirmed a cardiac cavernous haemangioma. The patient had an uneventful postoperative recovery at the 8-month follow-up. Discussion Cardiac haemangioma is a benign tumour with no typical clinical manifestations, and very few patients may present with chest pain. Preoperative echocardiography, computed tomography, and MRI are helpful for diagnosis, and surgery can relieve symptoms and may improve the prognosis of patients with cardiac haemangioma.
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Affiliation(s)
- Manyun Tang
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, PR China
| | - Zhijie Jian
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, PR China
| | - Yang Yan
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, PR China
| | - Fengwei Guo
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an 710061, PR China
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Standridge M, Gaucher J, Burgin CM. Vascular Atypia in a Cardiac Myxoma Patient. Cureus 2021; 13:e18646. [PMID: 34786241 PMCID: PMC8577957 DOI: 10.7759/cureus.18646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 11/21/2022] Open
Abstract
Cardiac masses can manifest as a variety of signs and symptoms in adults. In this report, we report a case that highlights the value of advanced imaging of a newly symptomatic and previously undiagnosed cardiac neoplasm. In addition to the standard transthoracic and transesophageal echocardiography, cardiac catheterization may be employed to further understand the vascularity of such cardiac pathology prior to surgical intervention.
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Affiliation(s)
- Meaghan Standridge
- Department of Surgery, University of Tennessee Medical Center, Knoxville, USA
| | - Jay Gaucher
- Department of Medicine, Prisma Health, Greenville, USA
| | - Chelsea M Burgin
- Department of Emergency Medicine, Prisma Health, University of South Carolina School of Medicine, Greenville, USA
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Darbari A, Singh D, Gilbert S, Kumar B, Singh N. Capillary haemangioma of the heart presenting with pericardial effusion: A case report. J Cardiovasc Thorac Res 2021; 13:250-253. [PMID: 34630974 PMCID: PMC8493228 DOI: 10.34172/jcvtr.2020.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/18/2020] [Indexed: 11/28/2022] Open
Abstract
Cardiac haemangiomas (CH) are rare benign primary tumours of the heart and constitute nearly 2.8% of primary cardiac tumours. In a-48-year-old female, a cardiac tumour mass over right ventricular out flow area and main pulmonary artery was detected during diagnostic workup for aetiology of recurrent pericardial effusion. Echocardiograhy and pericardial fluid findings were non conclusive. Contrast enhanced Computed tomography (CECT) and Positron emission tomography (PET) scan imaging found the exophytic, moderately hypermetabolic, heterogeneous mass lesion posterolateral to main pulmonary trunk. We did partial resection of lesion without cardiac reconstruction and open incisional biopsy through midline sternotomy incision. Histopathological analysis confirmed this as a case of Capillary type of haemangioma of heart.
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Affiliation(s)
| | | | | | - Barun Kumar
- Department of Cardiology, AIIMS, Rishikesh-249203, India
| | - Neha Singh
- Department of Pathology, AIIMS, Rishikesh-249203, India
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Melo MDTD, Paiva MG, Santos MVC, Rochitte CE, Moreira VDM, Saleh MH, Brandão SCS, Gallafrio CC, Goldwasser D, Gripp EDA, Piveta RB, Silva TO, Santo THCE, Ferreira WP, Salemi VMC, Cauduro SA, Barberato SH, Lopes HMC, Pena JLB, Rached HRS, Miglioranza MH, Pinheiro AC, Vrandecic BALM, Cruz CBBV, Nomura CH, Cerbino FME, Costa IBSDS, Coelho Filho OR, Carneiro ACDC, Burgos UMMC, Fernandes JL, Uellendahl M, Calado EB, Senra T, Assunção BL, Freire CMV, Martins CN, Sawamura KSS, Brito MM, Jardim MFS, Bernardes RJM, Diógenes TC, Vieira LDO, Mesquita CT, Lopes RW, Segundo Neto EMV, Rigo L, Marin VLS, Santos MJ, Grossman GB, Quagliato PC, Alcantara MLD, Teodoro JAR, Albricker ACL, Barros FS, Amaral SID, Porto CLL, Barros MVL, Santos SND, Cantisano AL, Petisco ACGP, Barbosa JEM, Veloso OCG, Spina S, Pignatelli R, Hajjar LA, Kalil Filho R, Lopes MACQ, Vieira MLC, Almeida ALC. Brazilian Position Statement on the Use Of Multimodality Imaging in Cardio-Oncology - 2021. Arq Bras Cardiol 2021; 117:845-909. [PMID: 34709307 PMCID: PMC8528353 DOI: 10.36660/abc.20200266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
| | | | | | - Carlos Eduardo Rochitte
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital do Coração (HCOR), São Paulo, SP - Brasil
| | | | - Mohamed Hassan Saleh
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
| | | | | | - Daniel Goldwasser
- Hospital Federal de Ipanema, Rio de Janeiro, RJ - Brasil
- Hospital Copa D'Or, Rio de Janeiro, RJ - Brasil
- Casa de Saúde São José, Rio de Janeiro, RJ - Brasil
| | - Eliza de Almeida Gripp
- Hospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil
- Hospital Universitário Antônio Pedro, Rio de Janeiro, RJ - Brasil
| | | | - Tonnison Oliveira Silva
- Hospital Cardio Pulmonar - Centro de Estudos em Cardiologia, Salvador, BA - Brasil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brasil
| | | | | | - Vera Maria Cury Salemi
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
| | | | - Silvio Henrique Barberato
- CardioEco Centro de Diagnóstico Cardiovascular, Curitiba, PR - Brasil
- Quanta Diagnóstico, Curitiba, PR - Brasil
| | | | | | | | - Marcelo Haertel Miglioranza
- Instituto de Cardiologia do Rio Grande do Sul - Laboratório de Pesquisa e Inovação em Imagem Cardiovascular, Porto Alegre, RS - Brasil
- Hospital Mãe de Deus, Porto Alegre, RS - Brasil
| | | | | | | | - César Higa Nomura
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital Sírio-Libanês, São Paulo, SP - Brasil
| | - Fernanda Mello Erthal Cerbino
- Clínica de Diagnóstico por Imagem, Rio de Janeiro, RJ - Brasil
- Diagnósticos da América AS, Rio de Janeiro, RJ - Brasil
| | | | | | | | | | - Juliano Lara Fernandes
- Radiologia Clínica de Campinas, Campinas, SP - Brasil
- Instituto de Ensino e Pesquisa José Michel Kalaf, Campinas, SP - Brasil
| | - Marly Uellendahl
- Diagnósticos da América AS, Rio de Janeiro, RJ - Brasil
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brasil
| | | | - Tiago Senra
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil
- Hospital Sírio-Libanês, São Paulo, SP - Brasil
| | - Bruna Leal Assunção
- Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil
| | - Claudia Maria Vilas Freire
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG - Brasil
- ECOCENTER, Belo Horizonte, MG - Brasil
| | | | - Karen Saori Shiraishi Sawamura
- Hospital do Coração (HCOR), São Paulo, SP - Brasil
- Hospital Universitário Antônio Pedro, Rio de Janeiro, RJ - Brasil
- Instituto da Criança da Universidade de São Paulo (USP), São Paulo, SP - Brasil
| | - Márcio Miranda Brito
- Universidade Federal do Tocantins - Campus de Araguaina, Araguaina, TO - Brasil
- Hospital Municipal de Araguaina, Araguaina, TO - Brasil
| | | | | | | | | | - Claudio Tinoco Mesquita
- Hospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil
- Universidade Federal Fluminense (UFF), Rio de Janeiro, RJ - Brasil
- Hospital Vitória, Rio de Janeiro, RJ - Brasil
| | | | | | - Letícia Rigo
- Hospital Beneficência Portuguesa, São Paulo, SP - Brasil
| | | | | | - Gabriel Blacher Grossman
- Clínica Cardionuclear, Porto Alegre, RS - Brasil
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
| | | | - Monica Luiza de Alcantara
- Americas Medical City, Rio de Janeiro, Rio de Janeiro, RJ - Brasil
- Americas Serviços Médicos, Rio de Janeiro, RJ - Brasil
- Rede D'Or, Rio de Janeiro, RJ - Brasil
| | | | | | | | | | | | | | - Simone Nascimento Dos Santos
- Hospital Brasília - Ecocardiografia, Brasília, DF - Brasil
- Eccos Diagnóstico Cardiovascular Avançado, Brasília, DF - Brasil
| | | | | | | | | | | | - Ricardo Pignatelli
- Texas Children's Hospital, Houston, Texas - EUA
- Baylor College of Medicine, Houston, Texas - EUA
| | - Ludhmilla Abrahão Hajjar
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil
| | - Roberto Kalil Filho
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Universidade de São Paulo Instituto do Câncer do Estado de São Paulo, São Paulo, SP - Brasil
| | - Marcelo Antônio Cartaxo Queiroga Lopes
- Hospital Alberto Urquiza Wanderley - Hemodinâmica e Cardiologia Intervencionista, João Pessoa, PB - Brasil
- Hospital Metropolitano Dom José Maria Pires, João Pessoa, PB - Brasil
- Sociedade Brasileira de Cardiologia, Rio de Janeiro, RJ - Brasil
| | - Marcelo Luiz Campos Vieira
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP - Brasil
- Hospital Israelita Albert Einstein, São Paulo, SP - Brasil
| | - André Luiz Cerqueira Almeida
- Santa Casa de Misericórdia de Feira de Santana - Cardiologia, Feira de Santana, BA - Brasil
- Departamento de Imagem Cardiovascular da Sociedade Brasileira de Cardiologia, São Paulo, SP - Brasil
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Nguyen HC, Pham DT. Totally endoscopic resection of epicardial cardiac haemangioma under on-pump beating heart. Ann Med Surg (Lond) 2021; 69:102838. [PMID: 34527243 PMCID: PMC8433115 DOI: 10.1016/j.amsu.2021.102838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/06/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Cardiac haemangioma (CH) is an extremely rare type of benign heart tumor, with prevalence only 2.8% of all primary cardiac tumors. The symptoms of tumor are often nonspecific. Preoperative screening and diagnosis are based on imaging examinations. Radical surgical resection is indicated in symptomatic patients. Case presentation We report on a case of an incidentally found tumor located on the right-sided epicardium that was successfully removed with the totally endoscopic surgery (TES) and the concomitant use of cardiopulmonary bypass (CPB). Discussion Excision of these tumors has been described through a median sternotomy approach. In recent years, TES has grown in popularity with many advantages. On the other hand, on-pump beating-heart (ON–BH) technique has been appreciated as a superior myocardial preservation method. The combination of these procedure provides clinical benefits and patient preferences. Conclusion Totally endoscopic resection of CH under ON-BH is a safe, effective procedure, which can be adopted in similar cases. Surgical resection of cardiac haemangioma is the first-line treatment. Minimally invasive cardiac surgery has gradually replaced the sternotomy approach. On-pump beating-heart technique provides significantly lower morbidity and mortality. Totally endoscopic resection of tumor under a beating-heart is safe, effective.
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Affiliation(s)
- Huu Cong Nguyen
- Cardiovascular Center, E Hospital, 89 Tran Cung Street, Cau giay District, Hanoi, Viet Nam
| | - Dat Thanh Pham
- Cardiovascular Center, E Hospital, 89 Tran Cung Street, Cau giay District, Hanoi, Viet Nam
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Yildirim S, Işik M, Tanyeli Ö, Görmüş N. Giant left atrial capillary haemangioma invading left-main coronary artery. Interact Cardiovasc Thorac Surg 2021; 33:631-633. [PMID: 34000032 DOI: 10.1093/icvts/ivab133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/20/2021] [Accepted: 03/31/2021] [Indexed: 11/13/2022] Open
Abstract
Cardiac haemangiomas are rare cases and can be seen at any age of life. A 49-year-old woman was admitted to our hospital with chest pain. A well-circumscribed soft tissue mass extending from the pulmonary artery truncus to the left ventricular inferior neighborhood. Following surgical resection, the patient was discharged 4 days after surgery.
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Affiliation(s)
- Serkan Yildirim
- Department of Cardiovascular Surgery, Necmettin Erbakan University, Meram Medicine Faculty, Konya, Turkey
| | - Mehmet Işik
- Department of Cardiovascular Surgery, Necmettin Erbakan University, Meram Medicine Faculty, Konya, Turkey
| | - Ömer Tanyeli
- Department of Cardiovascular Surgery, Necmettin Erbakan University, Meram Medicine Faculty, Konya, Turkey
| | - Niyazi Görmüş
- Department of Cardiovascular Surgery, Necmettin Erbakan University, Meram Medicine Faculty, Konya, Turkey
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Kamata K, Hao H, Ishige T, Shimodai-Yamada S, Sezai A, Taoka M, Osaka S, Suzuki K, Tanaka M. Exophytic cavernous hemangioma arising from the right ventricle: Report of a rare case. Pathol Int 2021; 71:267-271. [PMID: 33559333 DOI: 10.1111/pin.13075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/13/2020] [Indexed: 11/28/2022]
Abstract
Cardiac hemangioma is relatively rare, accounting for approximately 1-3% of all primary heart tumors. This benign tumor may be an incidental lesion, but can also cause arrhythmias, pericardial effusion, congestive heart failure or outflow obstruction. We report a rare case with exophytic cardiac hemangioma arising from the right ventricle. Echocardiography showed an approximately 40 mm round protruding mass on the anterior wall of the right ventricle. Cardiovascular magnetic resonance demonstrated isointense and hyperintense signals on T1- and T2-weighted images, respectively. These imaging studies suggested a pericardial cyst. Perioperative findings indicated a globular, exophytic mass, vascular in nature, arising from the right ventricle. The lesion was resected directly, and the space left by defect in the right ventricular wall was covered with a bovine pericardial patch. Cardiac hemangiomas are generally endoluminal tumors, but we must keep in mind that the differential diagnoses include various pericardial lesions by medical images.
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Affiliation(s)
- Keita Kamata
- Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroyuki Hao
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Toshiyuki Ishige
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Sayaka Shimodai-Yamada
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Akira Sezai
- Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Makoto Taoka
- Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Shunji Osaka
- Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Keito Suzuki
- Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Masashi Tanaka
- Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
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Pradella S, Grazzini G, Letteriello M, De Amicis C, Grassi R, Maggialetti N, Carbone M, Palumbo P, Carotti M, Di Cesare E, Giovagnoni A, Cozzi D, Miele V. Masses in right side of the heart: spectrum of imaging findings. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:60-70. [PMID: 32945280 PMCID: PMC7944673 DOI: 10.23750/abm.v91i8-s.9940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/08/2020] [Indexed: 11/25/2022]
Abstract
Primary heart tumors are rare, benign tumors represent the majority of these. If a cardiac mass is found, the probability that it is a metastasis or a so-called “pseudo-mass” is extremely higher than a primary tumor. The detection of a heart mass during a transthoracic echocardiography (TE) is often unexpected. The TE assessment can be difficult, particularly if the mass is located at the level of the right chambers. Cardiac Computed Tomography (CCT) can be useful in anatomical evaluation and Cardiac Magnetic Resonance (CMR) for masses characterization as well. We provide an overview of right cardiac masses and their imaging futures. (www.actabiomedica.it)
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Affiliation(s)
- Silvia Pradella
- Department of Radiology, Careggi University Hospital, Florence, Italy.
| | - Giulia Grazzini
- Department of Radiology, Careggi University Hospital, Florence, Italy.
| | - Mayla Letteriello
- Department of Radiology, Careggi University Hospital, Florence, Italy.
| | | | - Roberta Grassi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Nicola Maggialetti
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
| | - Mattia Carbone
- Department of Radiology, S. Giovanni and Ruggi D'Aragona Hospital, Salerno, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Marina Carotti
- Università politecnica delle Marche, School of Medicine and University Hospital "Umberto I-Lancisi-Salesi", Department of Radiology, Ancona, Italy.
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Andrea Giovagnoni
- Università politecnica delle Marche, School of Medicine and University Hospital "Umberto I-Lancisi-Salesi", Department of Radiology, Ancona, Italy.
| | - Diletta Cozzi
- Department of Radiology, Careggi University Hospital, Florence, Italy.
| | - Vittorio Miele
- Department of Radiology, Careggi University Hospital, Florence, Italy.
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Tsukioka K, Kono T, Takahashi K, Tominaga Y, Sano K. Concomitant Resection of Left Ventricular Hemangioma and Lung Cancer With Ground-Glass Opacity. Ann Thorac Surg 2019; 110:e9-e11. [PMID: 31877293 DOI: 10.1016/j.athoracsur.2019.10.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/25/2019] [Accepted: 10/27/2019] [Indexed: 11/27/2022]
Abstract
We report a case of concomitant left ventricular tumor and lung lesion with ground-glass opacity without preoperative confirmation of malignancy. To obtain definitive diagnosis, a wedge lung resection was performed through a median sternotomy. After confirmation of a negative margin by frozen section, the cardiac tumor was resected through a left anterior ventriculotomy. Histopathologic analysis identified a rare cardiac hemangioma and an adenocarcinoma with pTis, N0, M0, stage 0. Postoperative recovery was uneventful with intact cardiopulmonary functions despite the risk of low cardiac output attributable to ventriculotomy.
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Affiliation(s)
- Katsuaki Tsukioka
- Department of Thoracic and Cardiovascular Surgery and Department of Pathology, Iida Municipal Hospital, Iida, Japan.
| | - Tetsuya Kono
- Department of Cardiovascular Surgery, Suwa Red Cross Hospital, Suwa, Japan
| | - Kohei Takahashi
- Department of Thoracic and Cardiovascular Surgery and Department of Pathology, Iida Municipal Hospital, Iida, Japan
| | - Yoshiaki Tominaga
- Department of Thoracic and Cardiovascular Surgery and Department of Pathology, Iida Municipal Hospital, Iida, Japan
| | - Kenji Sano
- Department of Pathology, Iida Municipal Hospital, Iida, Japan
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Abstract
We present a case of a large left ventricular capillary haemangioma incidentally discovered in a pre-adolescent patient.
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Kotoulas C, Georgiou C, Grapatsas K, Kotoulas S, Theodosiadis N, Panagiotou I. Cavernous hemangioma of the left atrium: A rare tumor. J Card Surg 2019; 35:202-203. [PMID: 31765014 DOI: 10.1111/jocs.14373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Konstantinos Grapatsas
- Department of Thoracic Surgery, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany
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Rathore K, Yussouf R, Teh M, Jindal S, Wong D, Newman M. Left Atrial Anastomosing Hemangioma Causing Recurrent Pericardial Effusion. Ann Thorac Surg 2019; 109:e157-e159. [PMID: 31430463 DOI: 10.1016/j.athoracsur.2019.06.082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/20/2019] [Indexed: 11/26/2022]
Abstract
We report an extremely rare tumor in an adult patient who presented with recurrent pericardial effusion. The mass was an extracardiac tumor on the left atrial roof, which was excised by open heart surgery. Histologic examination confirmed a cardiac anastomosing hemangioma.
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Affiliation(s)
- Kaushalendra Rathore
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
| | - Reza Yussouf
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Mark Teh
- Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Shalini Jindal
- Anatomical Pathology, PathWest, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - Daniel Wong
- Anatomical Pathology, PathWest, Queen Elizabeth II Medical Centre, Nedlands, Western Australia, Australia
| | - Mark Newman
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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Liddy S, McQuade C, Walsh KP, Loo B, Buckley O. The Assessment of Cardiac Masses by Cardiac CT and CMR Including Pre-op 3D Reconstruction and Planning. Curr Cardiol Rep 2019; 21:103. [DOI: 10.1007/s11886-019-1196-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abuharb MYI, Bian XM, He J. Epicardial cardiac cavernous Haemangioma-a case report. BMC Cardiovasc Disord 2019; 19:179. [PMID: 31357944 PMCID: PMC6664696 DOI: 10.1186/s12872-019-1156-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/15/2019] [Indexed: 11/13/2022] Open
Abstract
Background Cardiac haemangiomas are exceptionally rare. They are usually solitary growths. Cardiac haemangiomas can be classified as capillary, cavernous, or arteriovenous in nature. They can occur in any chambers of the heart, but are predominantly found at the intramural or endocardial layers. Case presentation This is a rare case of a cardiac haemangioma located on the epicardium of a 52-year-old male patient. The patient complained of 1-year duration of chest tightness and shortness of breath. The haemangioma was removed successfully. For symptomatic lesions, surgical removal remains the preferred treatment. Conclusion The pathological diagnosis was primary cardiac cavernous haemangioma. In this case, the haemangioma was successfully resected with invasive surgery. No recurrence was detected on follow up.
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Affiliation(s)
| | - Xiao Ming Bian
- The first affiliated hospital of Dalian Medical University, Lianhe Avenue, Dalian, China
| | - Jian He
- The first affiliated hospital of Dalian Medical University, Lianhe Avenue, Dalian, China.
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Lamanna A, Lim RP, Yap LP, Maingard J, Seevenayagam S. Enlarging left atrial haemangioma in a patient with Cowden syndrome. BMJ Case Rep 2019; 12:12/7/e230088. [PMID: 31352392 DOI: 10.1136/bcr-2019-230088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 53-year-old female patient known to have Cowden disease (PTEN mutation positive) was found to have a mass at the left atrium on a CT coronary angiography performed as part of a preoperative workup for an unrelated surgery. Further radiological characterisation of the lesion was achieved using MRI and positron emission tomography. Interval growth prompted surgical excision; however, surgery was expedited after the patient presented with haemopericardium and cardiac tamponade. The patient was discharged home 8 days postoperatively, and no intraoperative or postoperative complications were encountered. A diagnosis of cavernous haemangioma was made on histology.
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Affiliation(s)
- Anthony Lamanna
- Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
| | - Ruth P Lim
- Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
| | - Lee Pheng Yap
- Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
| | - Julian Maingard
- Department of Radiology, Monash Health, Clayton, Victoria, Australia
| | - Siven Seevenayagam
- Department of Thoracic Surgery, Austin Health, Heidelberg, Victoria, Australia
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Drucker A, Zhou C, Seevanayagam S, Weinberg L. Left atrial cavernous haemangioma presenting with cardiac tamponade in a patient with Cowden syndrome. BMJ Case Rep 2019; 12:12/7/e229741. [PMID: 31289165 DOI: 10.1136/bcr-2019-229741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Cowden syndrome (CS) is a rare disorder characterised by multiple non-cancerous, tumour-like growths called hamartomas. The syndrome is associated with the development of cancer of the breast, endometrium, kidneys, skin and rarely the brain. We report a rare case of symptomatic cardiac haemangioma in a patient with CS. A 54-year-old woman with CS presented with dyspnoea and orthopnoea in the setting of cardiac tamponade. Echocardiography revealed a large haemopericardium and tamponade physiology, secondary to a pericardial mass. The patient underwent urgent cardiopulmonary bypass with removal of the mass. Histopathology confirmed a benign cavernous haemangioma. We postulate that tumours involving the heart/pericardium may be an additional manifestation of CS. This case further highlights the necessity to consider pericardial/cardiac manifestations in patients with hamartomatous syndromes who present with cardiorespiratory symptoms, so that opportunistic investigation and treatment may be instituted.
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Affiliation(s)
- Alexandra Drucker
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
| | - Chong Zhou
- Department of Pathology, Austin Health, Heidelberg, Victoria, Australia
| | - Siven Seevanayagam
- Department of Cardiac Surgery, Austin Health, Heidelberg, Victoria, Australia
| | - Laurence Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.,Surgery and Anaesthesia Preoperative Pain Medicine Unit, University of Melbourne, Melbourne, Victoria, Australia
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