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Kaddoura R, El Rassi I, Al Awadi Z, Kasem M. Congenital Blood Cyst of a Child: A case report and review of literature. Sultan Qaboos Univ Med J 2024; 24:276-278. [PMID: 38828236 PMCID: PMC11139362 DOI: 10.18295/squmj.5.2023.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/30/2023] [Accepted: 05/03/2023] [Indexed: 06/05/2024] Open
Abstract
Blood-filled cysts of the heart valves are frequently reported at postpartum autopsies of infants. They are seen as round nodules mostly in the paediatric age group in infants less than 2 months of age and disappear spontaneously within 6 months of life. We report a unique case of an 11-month-old girl who presented at a tertiary healthcare hospital in 2022 with a blood-filled cyst on the posterior leaflet of the pulmonary valve that was successfully treated. This case report highlights the characteristics and course of a paediatric patient with blood-filled cysts. Further studies are yet needed to better understand the diagnostic approaches to blood-filled cysts as well as treatment modalities to fill the gap in clinical settings.
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Affiliation(s)
- Rachid Kaddoura
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Issam El Rassi
- Al Jalila Children’s Speciality Hospital, Dubai, United Arab Emirates
| | - Zainab Al Awadi
- Al Jalila Children’s Speciality Hospital, Dubai, United Arab Emirates
| | - Mohamed Kasem
- Al Jalila Children’s Speciality Hospital, Dubai, United Arab Emirates
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2
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Ding Y, Wang W, Tan Q, Zhang S, Zhang X, Jin B, Xie Y. Sudden unexpected death from subvalvular hemorrhagic cyst complicated with coronary heart disease in an adult. Forensic Sci Med Pathol 2024; 20:194-198. [PMID: 36944826 DOI: 10.1007/s12024-023-00614-5] [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: 03/08/2023] [Indexed: 03/23/2023]
Abstract
Cardiac blood cysts are rare benign tumors. It is commonly found in the heart valve and left ventricle of newborns by autopsy and is rarely seen in adults [1, 2]. The typical histopathology of cardiac blood cysts is a closed, round, blood-containing cystic mass attached to the heart valve or endocardium. This article reports a rare case of sudden death due to a giant subaortic cardiac blood cyst with coronary heart disease in an adult patient and summarizes the pathological features, aiming to provide a reference for the forensic pathological identification of cardiac blood cysts.
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Affiliation(s)
- Yanjie Ding
- College of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Wei Wang
- College of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Qiufeng Tan
- Department of Criminal Technology, Wuhou District Branch of Chengdu Public Security Bureau, Chengdu, China
| | - Shilin Zhang
- College of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xiao Zhang
- College of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Bo Jin
- College of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China.
| | - Ying Xie
- College of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China.
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3
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Wang X, Yang Y, Zhang Y, Fan L, Wang S. Blood cyst of the pulmonary valve causing right ventricular outflow tract obstruction: A case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:347-350. [PMID: 34655250 DOI: 10.1002/jcu.23086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/02/2021] [Accepted: 10/03/2021] [Indexed: 06/13/2023]
Abstract
Blood cysts are rare cardiac tumors, often involve the atrioventricular valves. Blood cysts are usually small and tend to be clinically silent. Here, we report a case of blood cyst adhered to the junction of the pulmonary valve and the right ventricular outflow, causing severe outflow obstruction. This case was initially misdiagnosed as pulmonary valve stenosis by transthoracic echocardiography (TTE) and even underwent percutaneous balloon pulmonary valvuloplasty (PBPV). As the right ventricle-to-pulmonary artery peak gradient did not decrease after PBPV procedure, the boy underwent TTE again and the diagnosis was corrected as blood cyst. The cystic mass was successfully resected subsequently, and the boy recovered well.
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Affiliation(s)
- Xiaoyan Wang
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yanfeng Yang
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yong Zhang
- Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Structural Heart Disease, Guangzhou, China
| | - Lingxia Fan
- Department of Pediatric Cardiology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shushui Wang
- Department of Pediatric Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Structural Heart Disease, Guangzhou, China
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Bortolotti U, Vendramin I, Lechiancole A, Sponga S, Pucci A, Milano AD, Livi U. Blood cysts of the cardiac valves in adults: Review and analysis of published cases. J Card Surg 2021; 36:4690-4698. [PMID: 34519088 DOI: 10.1111/jocs.15992] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIM Blood cysts of cardiac valves are generally seen in newborns and infants and very rarely in adults. Although in most cases they are incidental findings they may be associated to severe cardiac or systemic complications. This study analyzes incidence, presentation, and treatment of valvular blood cysts in adults. METHODS A review of the pertinent literature through a search mainly on PubMed and Medline was performed. RESULTS In patients ≥18 years of age, our search disclosed 54 patients with mitral blood cysts (mean age, 48 ± 18 years), 9 with a tricuspid valve cyst (mean age, 67 ± 15 years), 3 with a blood cyst on the pulmonary valve (age 31, 43, and 44 years), and 1 aortic valve cyst in a 22-year-old man. Most patients were asymptomatic while stroke, syncope, or myocardial infarction occurred in six patients with a mitral valve cyst. Blood cysts were removed surgically in 70% of patients with a mitral cyst, in 55% with a tricuspid cyst, and in all those with a pulmonary or aortic cyst. At histology, the cyst wall was composed mainly by fibrous tissue and with the inner surface lined with typical endothelium. CONCLUSIONS Blood cysts of cardiac valves are rare in adults but may cause life-threatening complications, particularly when located on the mitral valve. For such reason, surgical removal appears advisable, with low-risk procedures. Widespread use of multimodality imaging techniques will most likely increase the number of valvular blood cysts diagnosed also in adults.
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Affiliation(s)
- Uberto Bortolotti
- Cardiothoracic Department, University Hospital of Udine, Udine, Italy
| | - Igor Vendramin
- Cardiothoracic Department, University Hospital of Udine, Udine, Italy
| | | | - Sandro Sponga
- Cardiothoracic Department, University Hospital of Udine, Udine, Italy
| | - Angela Pucci
- Division of Pathology, Pisa University Hospital, Pisa, Italy
| | - Aldo D Milano
- Division of Cardiac Surgery, University of Bari Aldo Moro, Bari, Italy
| | - Ugolino Livi
- Cardiothoracic Department, University Hospital of Udine, Udine, Italy
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5
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Beale RA, Russo R, Beale C, Levin W, Atalay MK, Fingleton J, Poppas A, Apostolidou E. Mitral Valve Blood Cyst Diagnosed with the Use of Multimodality Imaging. ACTA ACUST UNITED AC 2021; 5:173-176. [PMID: 34195517 PMCID: PMC8236382 DOI: 10.1016/j.case.2021.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Intracardiac blood cyst is a rare congenital abnormality that can be found in adults. It is most commonly attached in the valves, particularly the mitral valve. Echocardiography is the imaging modality of choice for the diagnosis of blood cyst. Cardiac MRI contributes to the diagnosis, typically showing absence of cyst enhancement. Conservative management is reasonable in the absence of effects on cardiac function.
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Affiliation(s)
| | - Ronald Russo
- Department of Medicine, SUNY Upstate, Syracuse, New York
| | - Charles Beale
- Hawthorne Medical Associates, Dartmouth, Massachusetts
| | - William Levin
- Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Michael K Atalay
- Department of Diagnostic Imaging, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - James Fingleton
- Department of Cardiology and Cardiothoracic Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Athena Poppas
- Department of Cardiology and Cardiothoracic Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Eirini Apostolidou
- Department of Cardiology and Cardiothoracic Surgery, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Abstract
Cardiac valve cysts are rare beyond infancy. The tricuspid and mitral valve are the most common sites, with few reported cases of pulmonary valve cysts in the literature. This case illustrates a pulmonary valve cyst mimicking a tumour in a child 13 years after cardiac surgery. Although these lesions are extremely rare, they could be considered in the differential diagnosis in patients presenting with valvular mass lesions.
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8
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Park MH, Jung SY, Youn HJ, Jin JY, Lee JH, Jung HO. Blood cyst of subvalvular apparatus of the mitral valve in an adult. J Cardiovasc Ultrasound 2012. [PMID: 23185658 PMCID: PMC3498312 DOI: 10.4250/jcu.2012.20.3.146] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Blood cysts of the heart are rare benign tumors, usually involving the cardiac valves. They are found mainly in the first month of life and in children; and are rarely seen in adults. Here, we report a case of a blood cyst on the subvalvular apparatus of the mitral valve, which was incidentally discovered during chest computed tomography in a 47-year-old man. To the best of our knowledge, this is the first reported case of blood cyst of the heart in an adult in Korea.
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Affiliation(s)
- Mi Hee Park
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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9
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Abstract
This report describes the diagnosis and surgical management of a pulmonary valve cystic mass in a symptomatic 7-year-old boy. Cardiac valve cysts are extremely rare beyond the age of 6 months and typically not associated with symptoms. These lesions may grow, leading to progressive stenosis, regurgitation, or ventricular outflow tract obstruction. Therefore, these lesions should be monitored for change in size and/or, hemodynamic changes. Surgical intervention may be required for symptomatic patients.
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Ayati M, Gori T, Münzel T. Lesions of the mitral valve as a cause of central retinal artery occlusion: presentation and discussion of two cases. Echocardiography 2009; 27:E1-3. [PMID: 20070361 DOI: 10.1111/j.1540-8175.2009.01016.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We present two cases of mitral valve lesions that manifested with unilateral blindness caused by central retinal artery occlusion (CRAO): Case 1. A 68-year-old woman was admitted to our clinic for sudden blindness. Retinal artery angiogram showed CRAO. Transthoracic and transesophageal echocardiography (TEE) documented a mass attached to the ventricular side of the posterior mitral leaflet, which at pathology was identified as a blood cyst. Case 2. A 67-year-old man was admitted for a sudden unilateral painless loss of vision. Retinal angiogram documented CRAO, and TEE showed a highly mobile, spherical, lesion on the atrial side of anterior mitral leaflet. In this case, the pathological finding was a degenerated calcified thrombosis. We report on two cases of very rare abnormalities of the mitral valve presenting with a very rare embolic complication, i.e., CRAO. Like for cryptogenic stroke, transesophageal echocardiography plays a central role in the diagnosis of cardiogenic embolic sources.
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Affiliation(s)
- Maryam Ayati
- Echocardiography Laboratory, Uniklinikum Mainz, Germany
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11
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Dencker M, Jexmark T, Hansen F, Tydén P, Roijer A, Lührs C. Bileaflet blood cysts on the mitral valve in an adult. J Am Soc Echocardiogr 2009; 22:1085.e5-8. [PMID: 19733795 DOI: 10.1016/j.echo.2009.04.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2008] [Indexed: 11/29/2022]
Abstract
Blood cysts within the heart are very rare entities in adults. The authors present possibly the first ever case in which blood cysts were found on both mitral valve leaflets. A 65-year-old woman was referred for transthoracic echocardiography because of vague chest discomfort. Transthoracic echocardiography displayed echo-free cysts on the tips of both mitral valve leaflets. Subsequent transesophageal echocardiography confirmed this finding. The blood cysts were successfully surgically removed.
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Affiliation(s)
- Magnus Dencker
- Department of Clinical Physiology, University Hospital MAS, Malmö, Sweden.
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Agac MT, Acar Z, Turan T, Karadag B, Kul S, Erkan H. Blood cyst of tricuspid valve: an incidental finding in a patient with ventricular septal defect. Eur Heart J Cardiovasc Imaging 2009; 10:588-9. [DOI: 10.1093/ejechocard/jep029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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13
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Park JP, Song JM, Lee JW, Kim GJ, Lee JW, Kim KE, Kang JW, Kang DH, Song JK. A Blood-Filled Cystic Mass Attached to the Anterolateral Papillary Muscle. J Cardiovasc Ultrasound 2009. [DOI: 10.4250/jcu.2009.17.1.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Jong Pil Park
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Min Song
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong-Woo Lee
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gyung Jung Kim
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Won Lee
- Department of Thoracic & Cardiovasuclar Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Eun Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joon-Won Kang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Duk-Hyun Kang
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Kwan Song
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kuvin J, Saha P, Rastegar H, Salomon RN, Pandian N, Denofrio D. Blood cyst of the mitral valve apparatus in a woman with a history of orthotopic liver transplantation. J Am Soc Echocardiogr 2004; 17:480-2. [PMID: 15122193 DOI: 10.1016/j.echo.2004.01.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Blood cysts within the heart are rare findings in adults. We describe a case of a woman with a history of orthotopic liver transplantation who presented for an echocardiogram to evaluate a potential source of cerebrovascular embolism. A cystic mass attached to the submitral valve apparatus was identified by transthoracic and confirmed by transesophageal echocardiography. Surgical exploration and pathologic examination confirmed the mass to be a blood cyst attached to the chordal apparatus of the posterior papillary muscle. This case report highlights the use of echocardiography in diagnosing intracardiac blood cysts.
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Affiliation(s)
- Jeffrey Kuvin
- Division of Cardiology, Department of Medicine, Tufts-New England Medical Center, Boston, MA 02111, USA.
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15
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Abstract
We report a rare case of giant blood cyst originating from the anterior mitral valve leaflet and chordae tendineae, which was incidentally discovered during a 2-dimensional echocardiography examination performed for assessment of left ventricular function after an uncomplicated myocardial infarction in a 50-year-old man.
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Affiliation(s)
- H M Pelikan
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA
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Affiliation(s)
- W C Boyd
- Department of Anesthesiology, Weill Medical College of Cornell University, New York, NY 10021, USA
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