Pulmonary subvalvular tumor

Congenital Blood Cyst of a Child: A case report and review of literature

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.

Clinical and echocardiographic characteristics of cardiac blood cysts

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.

Blood cyst of the pulmonary valve causing right ventricular outflow tract obstruction: A case report

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.

Double Right Atrial Blood Cysts

Blood cysts are exceedingly rare benign cardiac tumors, generally involving the cardiac valves. They are found mainly in the first month of life and in children and are very uncommon in adults. We present a rare case of double right atrium blood cysts, incidentally detected by transthoracic echocardiography in an 85-year old patient.

Intracardiac eustachian valve cyst in an adult detected with other cardiac anomalies: usefulness of multidetector CT in diagnosis

We present an unusual case of an intracardiac Eustachian valve cyst observed concurrently with atresia of the coronary sinus ostium, a persistent left superior vena cava (LSVC) and a bicuspid aortic valve. There have been several echocardiographic reports of Eustachian valve cysts; however, there is no report of multidetector computed tomography (MDCT) findings related to a Eustachian valve cyst. Recently, we observed a Eustachian valve cyst diagnosed on MDCT showing a hypodense cyst at the characteristic location of the Eustachian valve (the junction of the right atrium and inferior vena cava). MDCT also demonstrated additional cardiovascular anomalies including atresia of the coronary sinus ostium and a persistent LSVC and bicuspid aortic valve.

Giant pulmonary valve cyst in a 7-year-old child

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.

Endocardial blood cyst: a rare site and age of presentation

Cardiac blood cysts are rare findings in clinical practice. They usually involve the valves and are very uncommon in adult age. Their clinical manifestation varies broadly, as they can interfere with intracardiac flow, or even be completely silent. We report a case of a newly developed cyst of the atrial septum, incidentally detected by transthoracic echocardiography in a 69-year-old asymptomatic patient. The diagnosis was confirmed by postsurgery histopathological examination.

Blood cyst of the right ventricle presenting as recurrent high fever and chills in an adult

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.

Right atrial blood cyst with total occlusion of the right coronary artery

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.

Atrial blood cyst with ischemic heart disease

A 52-year-old male with coronary artery disease had the extremely rare occurrence of a blood cyst in the right atrium. Surgical removal with coronary artery bypass grafting was performed successfully.

Giant blood cyst of the mitral valve

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.

Blood cyst of the pulmonary valve in an adult: report of a case and review of the literature

We report a case of a blood cyst originating from the pulmonary valve cusp of a 43-year-old Japanese woman with pulmonary stenosis. Cineangiography revealed a pedunculated tumor on the arterial surface of the pulmonary valve. It was successfully removed by a transpulmonary artery approach. The cyst contained old blood and calcified thrombi, and its wall consisted of collagenous fibrous tissue. Immunohistochemically, a monolayer of flat cells lining the cyst was confirmed as endothelium using antibodies to von Willebrand factor and CD34, as well as UEA-I lectin. To the best of our knowledge, blood cysts of the pulmonary valve are rare and only 10 such cases have been reported, including six pediatric cases. This case is the oldest and fifth adult patient with a blood cyst found on the pulmonary valve. A possible histogenesis is discussed.

Blood cyst with a calcium stone originating from the right atrial septum

Blood cysts of the heart in adults are extremely rare, and their origin is usually from the valvular apparatus. However, a case was encountered of a blood cyst originating from the right atrial septum of a 59-year-old woman. Furthermore the cyst contained calcium stone. The cyst with the stone was Successfully excised. Neither situation has been reported previously in the literature.

Blood cyst of the mitral valve: detection by transthoracic and transesophageal echocardiography

Two-dimensional transthoracic and transesophageal echocardiography have become important modalities in the evaluation of the mechanism of symptomatic mitral regurgitation. We report the use of echocardiography in the detection of an unusual cause of mitral regurgitation, that of multiple large blood cysts involving the posterior leaflet of the mitral valve.