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Baltodano-Arellano R, Alvarez-Tiburcio E, Barriales-Revilla L, Bellido-Yarlequé D, Cachicatari A, Cupe-Chacalcaje K, La Torre-Zuñiga A, Velarde-Acosta K. Case report and literature review: cardiac hematic cyst. Front Cardiovasc Med 2024; 11:1417074. [PMID: 39139751 PMCID: PMC11319172 DOI: 10.3389/fcvm.2024.1417074] [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: 04/14/2024] [Accepted: 07/18/2024] [Indexed: 08/15/2024] Open
Abstract
A 49-year-old female patient, asymptomatic, presented to the cardiology office for a right atrial mass, identified incidentally in a non-electrocardiogram (ECG)-gated contrast-enhanced computed tomography, performed for follow-up of pulmonary tuberculosis. Echocardiography, surprisingly, showed an anechogenic ovoid mass in the right atrium measuring 40 × 40 mm2, implanted in the interatrial septum without affecting the tricuspid valve. ECG-gated computed tomography angiography (CTA), confirmed the dimensions of the mass, which presented homogeneous content, calcified areas, and a 12-mm pedicle implanted near the ostium of the coronary sinus. Additionally, contrast uptake and infiltration of adjacent structures were ruled out. In the surgical field, an encapsulated mass with blood content was found, which pathology reported as a hematic endocardial cyst (HEC). These are rare cardiac masses, constituting 1.5% of all primary cardiac tumors. It is usually an incidental finding, and its clinical presentation will depend on its dimensions and the intracardiac hemodynamic impact. A highlighting feature is its anechogenic content on ultrasound, however, multimodality imaging allows for making diagnostic assumptions, discerning between primary cardiac tumors, and provides morphological and hemodynamic information useful for therapeutic decision making. The age of the patient, the large size of the HEC, and its location in the interatrial septum make up a completely atypical presentation of this rare disease, which motivated this report.
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Affiliation(s)
- Roberto Baltodano-Arellano
- Cardiac Imaging Area of Cardiology Service, Hospital Guillermo Almenara Irigoyen – EsSalud, Lima, Peru
- School of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | | | | | - Angela Cachicatari
- Cardiac Imaging Area of Cardiology Service, Hospital Guillermo Almenara Irigoyen – EsSalud, Lima, Peru
| | - Kelly Cupe-Chacalcaje
- Cardiac Imaging Area of Cardiology Service, Hospital Guillermo Almenara Irigoyen – EsSalud, Lima, Peru
| | - Alan La Torre-Zuñiga
- Pathological Anatomy Service, Hospital Edgardo Rebagliati Martins - EsSalud, Lima, Peru
| | - Kevin Velarde-Acosta
- Clinical Cardiology Service, Hospital Guillermo Almenara Irigoyen - EsSalud, Lima, Peru
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Li M, Hu W, Wang C, Wan L, Liang Y, Duan X, Zhang L, Meng H. Clinical and echocardiographic characteristics of cardiac blood cysts. J Cardiol 2022; 80:261-267. [PMID: 35589466 DOI: 10.1016/j.jjcc.2022.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/21/2022] [Accepted: 04/17/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cardiac blood cysts (BCs) are rare benign cardiac masses. This study aimed to summarize the clinical and echocardiographic characteristics and clinical outcomes of patients with BCs. METHODS This retrospective study enrolled patients diagnosed with BC between 2009 and 2021 at a single center in China. Their clinical and echocardiographic characteristics, management, and outcomes at follow-up are summarized. RESULTS The study population comprised 26 patients with BCs with a mean age of 40 ± 19 years (median, 42 years; range, 27-56 years). The cohort was predominantly male (16, 62%). Twenty-two (81%) patients were symptomatic: dyspnea or exertional dyspnea (11, 42%) and palpitations (6, 23%) were the most frequent symptoms. Most cysts appeared as single round, oval, or lobulated anechoic masses, measuring 4-30 mm (mean, 18 mm). Half of the BCs (13, 50%) were pedunculated and mobile, and the others swung with the movement of the valve. The mitral valve (13, 50%) was the most common site of occurrence, followed by the tricuspid valve (6, 23%), right atrium (4, 15%), and aortic valve (3, 12%). Contrast echocardiography, which was performed for two patients, revealed a closed cyst without bubbles. Five cases were complicated by left ventricular outflow tract obstruction and six by valve prolapse. Eighteen patients underwent surgery, and one received antiplatelet therapy. Cardiovascular or cerebrovascular events did not occur in any patient during the follow-up period. CONCLUSION Cardiac BCs are most commonly attached to the atrioventricular valve. Echocardiography is considered to be the most useful imaging modality for assessing BC. The management of patients with BC should be individualized based on the symptoms and associated complications.
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Affiliation(s)
- Muzi Li
- Department of Echocardiography, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Echocardiography, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Wenwen Hu
- Department of Echocardiography, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Cheng Wang
- Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Linyuan Wan
- Department of Echocardiography, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Liang
- Department of Echocardiography, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuejing Duan
- Department of Pathology, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liang Zhang
- Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hong Meng
- Department of Echocardiography, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Echocardiography, Fuwai Yunnan Cardiovascular Hospital, Kunming, China.
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Jiang S, Wang XC, Zhang YL, Yu W, Pei LP, Ma Y. Relato de Caso de Doença Cardíaca Valvular Complicada com um Cisto Sanguíneo no Átrio Direito. Revisão da Literatura. Arq Bras Cardiol 2021; 117:1202-1206. [PMID: 35613176 PMCID: PMC8757156 DOI: 10.36660/abc.20210063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/16/2021] [Indexed: 11/24/2022] Open
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Imai A, Enomoto Y, Shigeta O, Suzuki Y. Right atrial blood cyst in elderly patient: the timing of surgery. Asian Cardiovasc Thorac Ann 2020; 28:500-503. [PMID: 32757656 DOI: 10.1177/0218492320949406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A regular check up on a 59-year-old man showed a high carcinoembryonic antigen level in his blood. A computed tomography scan showed tumors in the right atrium. We performed tumor resection successfully. The resected specimen was found to be blood cysts that had developed from the right atrium to the inferior vena cava. Intracardiac blood cysts are generally observed in infants, spontaneously disappear during the first 6 months of life, and are located in the left side of heart and on atrioventricular valves. Therefore, this case is extremely rare. Also, it is worth considering the timing of this surgery.
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Affiliation(s)
- Akito Imai
- Department of Cardiovascular Surgery, Ibaraki Prefectural Central Hospital, Ibaraki, Japan.,Department of Cardiovascular Surgery, Hitachi General Hospital, Ibaraki, Japan
| | - Yoshiharu Enomoto
- Department of Cardiovascular Surgery, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | - Osamu Shigeta
- Department of Cardiovascular Surgery, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
| | - Yasuyuki Suzuki
- Department of Cardiovascular Surgery, Ibaraki Prefectural Central Hospital, Ibaraki, Japan
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Karagözlü S, Ramoğlu MG, Dikmen Yaman N, Eyileten Z, Almus E. Giant intracardiac blood cyst of the mitral valve in a pediatric patient: A case report. Echocardiography 2020; 37:922-925. [PMID: 32447785 DOI: 10.1111/echo.14706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 11/27/2022] Open
Abstract
Intracardiac blood cysts are rare congenital malformations most commonly located in the endocardium of semilunar or atrioventricular valves. They are predominantly seen in infants, especially below 2 months of age, and disappear spontaneously in the first 6 months of life making the detection of blood cysts a rare finding in the adult population. Although most patients are asymptomatic, they may occasionally present with obstruction, valvular dysfunction, or embolism. Herein, we present a 2.5-year-old female patient, who was successfully treated with surgical excision of an intracardiac blood cyst causing mild-to-moderate mitral regurgitation and obstruction.
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Affiliation(s)
- Selen Karagözlü
- Department of Pediatric Cardiology, Medical School, Ankara University, Ankara, Turkey
| | - Mehmet G Ramoğlu
- Department of Pediatric Cardiology, Medical School, Ankara University, Ankara, Turkey
| | - Nur Dikmen Yaman
- Department of Pediatric Cardiovascular Surgery, Medical School, Ankara University, Ankara, Turkey
| | - Zeynep Eyileten
- Department of Pediatric Cardiovascular Surgery, Medical School, Ankara University, Ankara, Turkey
| | - Eda Almus
- Department of Pediatric Radiology, Medical School, Ankara University, Ankara, Turkey
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Aydın C, Engin M, Kul S. Tricuspid regurgitation due to blood cyst. Echocardiography 2019; 36:2108-2109. [PMID: 31628761 DOI: 10.1111/echo.14510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 09/26/2019] [Indexed: 11/28/2022] Open
Abstract
Cardiac blood cysts are confirmed by autopsies in stillbirths but rarely detected in adults. Although cardiac blood cysts are common in newborns, they disappear within a few months after birth. These cysts are blood-filled diverticula surrounded by endothelium. Their possible etiology is invaginations of atrial endothelium into the stroma of atrioventricular valves. Most blood cysts originate from the left side of the heart and are located on the atrioventricular valves. Complication is followed in very little cases, such as embolic stroke, valvular dysfunction, and ventricular outflow system obstruction. The blood cysts leading to complications should be removed surgically.
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Affiliation(s)
- Cihan Aydın
- Department of Cardiology, Ahi Evren Thoracic and Vascular Surgery Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Mesut Engin
- Department of Cardiovascular Surgery, Esentepe Mah., Ertuğrul Cad., Mehmet Akif İnan Training and Research Hospital, University of Health Sciences, Karaköprü/Şanlıurfa, Türkiye
| | - Selim Kul
- Department of Cardiology, Ahi Evren Thoracic and Vascular Surgery Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
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Özmen G, Demir M, Arı H, Aktaş İ. A rare association: concomitant presence of mitral valve blood cyst with atrial septal aneurysm and cor triatriatum dexter. Anatol J Cardiol 2015; 15:502-3. [PMID: 26006139 PMCID: PMC5779145 DOI: 10.5152/akd.2015.5984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Gökhan Özmen
- Department of Cardiology, Bursa Yüksek İhtisas Education and Research Hospital; Bursa-Turkey.
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Zhang F, Yin N, Yin B, Xu S, Yang Y. Giant right atrial cystic hamartoma: a case report and literature review. BMJ Case Rep 2009; 2009:bcr02.2009.1587. [PMID: 21686985 DOI: 10.1136/bcr.02.2009.1587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
UNLABELLED An 11-year-old boy presenting with palpitation and chest distress was found to have gross cardiomegaly on chest radiography. Subsequent echocardiography revealed an intramural giant cystic mass in the right atrium. An operative measure was planned to prevent acute cardiac tamponade and right coronary artery obstruction. The patient successfully underwent open cystectomy to remove the mass, which was located on the front wall of the right atrium and extended to the atrioventricular appendage. Histopathological examination confirmed a cystic hamartoma. To the best of our knowledge, this is the first reported case of a giant cystic hamartoma located on the right atrium. TRIAL REGISTRATION NUMBER 704640.
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Affiliation(s)
- Fei Zhang
- Department of Thoracic and Cardiovascular, the 2nd Xiangya Hospital, Center South University, Changsha, Hunan, P.R. China, 410011
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Dumantepe M, Ak K, Mungan U, Alp I, Inan BK, Yilmaz AT. Blood cyst of the right ventricle presenting as recurrent high fever and chills in an adult. Ann Thorac Surg 2009; 87:638-40. [PMID: 19161805 DOI: 10.1016/j.athoracsur.2008.06.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2008] [Revised: 06/02/2008] [Accepted: 06/04/2008] [Indexed: 10/21/2022]
Abstract
Blood cysts are uncommon primary cardiac tumors, frequently encountered in pediatric patients, but extremely rare when found in adults. Due to the considerable risks of embolization and obstruction of the blood flow, surgical removal is preferred. Herein, we report a case of blood cyst of the right ventricle, presenting as recurrent fever and chills in an adult patient.
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Affiliation(s)
- Mert Dumantepe
- Department of Cardiovascular Surgery, GATA Haydarpasa Education Hospital, Kadiköy, Istanbul, Turkey.
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Otsuka K, Terasaki F, Iimori A, Tonari S, Shimomura H, Ito T, Kitaura Y, Kanki-Horimoto S, Katsumata T. Right atrial blood cyst with total occlusion of the right coronary artery. Heart Vessels 2007; 22:208-10. [PMID: 17533527 DOI: 10.1007/s00380-006-0972-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2006] [Accepted: 12/22/2006] [Indexed: 10/23/2022]
Abstract
Cardiac blood cysts are rarely seen in adult patients and in the right atrium. The origin of cardiac blood cysts is not understood, and several hypotheses have been proposed. We present a rare case of right atrial blood cyst with total occlusion of the right coronary artery (RCA). Inflammatory processes may have played an important role in the development of the cyst, because infiltration of inflammatory cells was observed in the cystic wall. Additionally, total obstruction of the proximal RCA indicated that ischemia and/or infarction in the right atrium might be related to formation of the cyst.
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Affiliation(s)
- Kaoru Otsuka
- Department of Internal Medicine III, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
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