Cardiac Hemangioma of the Right Atrium: A Possible Cause of Cerebellar Stroke

Pasquino, Stefano; Balucani, Clotilde; Bella, Isidoro Di; Alberti, Andrea; Col, Uberto Da; Caso, Valeria; Ramoni, Enrico; Paciaroni, Maurizio; Agnelli, Giancarlo; Ragni, Temistocle

doi:10.1159/000103623

Cited by 8 publications

(5 citation statements)

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“…[3,6,9,10,25,26,27]. In addition to these symptoms, the presenting symptoms of a cardiac hemangioma localized elsewhere than on the valves may be arrhythmias [28,29], embolic incidents [30,31,32], sudden cardiac death [33], pericardial effusion [34,35] and heart tamponade [36]. Echocardiography may raise suspicion of this rare tumor; however, it may be very challenging as less than one third of reported cases of hemangiomas were diagnosed preoperatively [37].…”

Section: Discussionmentioning

confidence: 99%

An Exceptional Cause of Progressive Dyspnoea in a Renal Transplant Recipient: Hemangioma of the Mitral Valve

Jurić

Hadžibegović

Kes

et al. 2013

Kidney Blood Press Res

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Primary cardiac hemangioma is a very rare benign vascular tumor, with valvular hemangiomas being even less frequent as valves are generally avascular structures. We present the first case of mitral valve hemangioma in a renal transplant recipient. Patient presented with progressive dyspnea. Transesophageal echocardiogram (TEE) demonstrated a 0.8x0.9-cm pedunculated tumor mass on the posterior leaflet of the mitral valve. Coronary angiography identified a small artery which filled from the circumflex artery and fed the tumor. The tumor was surgically removed. Histopathological examination revealed a hemangioma. The postoperative course was uneventful with stable graft function.

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Section: Discussionmentioning

confidence: 99%

An Exceptional Cause of Progressive Dyspnoea in a Renal Transplant Recipient: Hemangioma of the Mitral Valve

Jurić

Hadžibegović

Kes

et al. 2013

Kidney Blood Press Res

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“…[10][11] The tumors arising from the right atrium present with constitutional symptoms, right heart failure, arrhythmias, syncope or ischemic heart symptoms. 12 To our knowledge, stroke has been related to right atrial tumors only in three cases: in a primary cardiac lymphoma, 13 in a cardiac hemangioma 14 and in a myxoma, 15 two of them coexisting with PFO. 14,15 In the case of our patient, it is also reasonable to assume that the source of the embolus that caused his stroke came from the right atrium through the PFO.…”

Section: Brief Communicationsmentioning

confidence: 93%

“…12 To our knowledge, stroke has been related to right atrial tumors only in three cases: in a primary cardiac lymphoma, 13 in a cardiac hemangioma 14 and in a myxoma, 15 two of them coexisting with PFO. 14,15 In the case of our patient, it is also reasonable to assume that the source of the embolus that caused his stroke came from the right atrium through the PFO. Embolic tumor fragments are improbable because the lipoma was not easily breakable as it had a smooth surface and was encapsulated.…”

Section: Brief Communicationsmentioning

confidence: 93%

“…Therefore, it is more plausible to consider that the abnormal motility of the right atrium owing to the dilatation caused by the lipoma, could favor the development of transient arrhythmias and/or a turbulent flow with the formation of thrombus that could reach the brain through the PFO. 14 The PFO was diagnosed firstly by TCD bubble study and then confirmed with TEE and it was not associated with a lipomatous hypertrophy of the interatrial septum. The possibility of a paradoxical embolism from an unrecognized peripheral venous thrombosis that lead to the incidental finding of the lipoma must also be considered although determining the pathological relevance of PFO for the stroke etiology in a particular patient is difficult when concurrent risk factors are present.…”

Section: Brief Communicationsmentioning

confidence: 99%

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Anterior Thalamic Infarction as Initial Manifestation of a Right Atrial Lipoma

Erro

Ajuria

Olaz

et al. 2009

Can. J. Neurol. Sci

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Cardiac tumors are an infrequent source of embolism to the brain in young adults. Myxomas are the most common among them and they are mainly located in the left atrium.1 Cardiac lipomas are a very rare benign neoplasm of the heart usually located in the right atrium.2,3 Its etiological relationship with stroke is not well established. We describe the case of a thalamic stroke probably caused by paradoxical embolism from a right atrial lipoma through a patent foramen ovale. CASE REPORTA 46-year-old male with mild hypertension, presented with speech and behavioral alterations first noticed on awakening without a previous Valsalva manoeuvre. On admission his blood pressure was 150/90 mm Hg, with a pulse of 70 beats/min and O 2 saturation of 97%. He was apyretic and cardiac and cervical auscultation was unremarkable. On neurologic examination, a non-fluent dysphasia with word finding difficulties, right facial paresis and a left Horner's syndrome was observed. He also presented mild right hemiparesis and myoclonic-dystonic movements in lower limbs (NIHSS 7). Cervical and Transcranial Doppler (TCD) were normal. Cranial computerized tomography was normal. A cranial magnetic resonance (MR) demonstrated on diffusion sequences the presence of an acute non-hemorrhagic infarction involving the anterior area of the left thalamus ( Figure 1A). Perfusion MR sequences and cerebral magnetic angioresonance were normal. The patient was admitted to the stroke unit. Conservative treatment was initiated. No arrhythmia was registered during hospitalization. Duplex sonography excluded atherosclerotic lesions in the carotid arteries. The next day, a right to left massive shunt was found on TCD bubble study ( Figure 1B). This test was performed using agitated saline as a contrast agent. Thrombophilic screening, neoplastic markers and autoimmune assays were negative. Transthoracic and transesophageal echocardiograms (TEE) were performed showing a mobile mass of homogeneous density attached to the free wall of the right atrium ( Figure 1C). No other cardioembolic lesions such as aortic plaques or dysfunctional left ventricle were found. The mass could be optimally assessed by cardiac MR as a well defined, slightly lobulated and homogeneous lesion, strongly hyperintense on T1 sequences, with low signal intensity on Fat-suppressed sequences (T2 STIR) and without contrast enhancement after gadolinium administration ( Figure 1D), highly suggestive of a lipoma. A patent foramen ovale (PFO) without associated aneurysmal septum could also be seen on TEE. The mass and the foramen ovale were surgically removed THE CANADIAN JOURNAL OF NEUROLOGICAL SCIENCES 379

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“…In addition, these patients may also experience some circulatory and respiratory manifestations, such as respiratory apnea syndrome, 12) cerebral stroke symptoms, and so on. 13) The hemangiomas of the heart are often concomitant with hepatic, skin, 14) pleural, 15) or pulmonary 16) hemangiomas. Therefore, for patients with clinical findings of atrial hemangioma, we recommend a systemic examination to determine whether other hemangioma lesions exist.…”

Section: Clinical Manifestationmentioning

confidence: 99%

Atrial Hemangioma: A Case Report and Review of the Literature

Miao

Yang²,

Zhou

et al. 2019

ATCS

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A primary cardiac tumor is a rare clinical entity which was reported an incidence of 0.03% in previous autopsy series. 75% cardiac tumors are cardiac myxoma and cardiac hemangiomas constitute only 1–2% of primary cardiac tumors. With the development of modern medical imaging technology and the enhancement of people’s health awareness, more and more asymptomatic cardiac hemangiomas were found and confirmed eventually. Here, we described a case of a 71-year-old man, who was hospitalized with intermittent palpitation for 1 year and a large mass of the heart was removed successfully via sternotomy which was confirmed as atrial hemangioma by postoperative histopathology. Furthermore, a comprehensive review of atrial hemangioma was conducted to date and a few recommendations for the diagnosis and treatment of this uncommon disorder were provided for clinicians.

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Cardiac Hemangioma of the Right Atrium: A Possible Cause of Cerebellar Stroke

Cited by 8 publications

References 4 publications

An Exceptional Cause of Progressive Dyspnoea in a Renal Transplant Recipient: Hemangioma of the Mitral Valve

An Exceptional Cause of Progressive Dyspnoea in a Renal Transplant Recipient: Hemangioma of the Mitral Valve

Anterior Thalamic Infarction as Initial Manifestation of a Right Atrial Lipoma

Atrial Hemangioma: A Case Report and Review of the Literature

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