Cardiac Lymphangioma Encasing Right Coronary Artery in an Infant

Abstract

Cardiac lymphangioma is a rare primary benign tumor of the heart. We report a 3-year-old with cystic lymphangioma encasing the right coronary artery. Cardiac magnetic resonance imaging confirmed a intra-pericardial heterogeneous mass measuring 2.6 × 2.4 × 3.9 cm and situated right anterolateral to the ascending aorta and extending into the right atrioventricular groove. Furthermore, the right coronary artery traversed through the center of the mass. Surgical resection, on cardiopulmonary bypass, consisted of excision by skeletonizing the right coronary artery along the length of the mass. The pathology report was consistent with a lymphatic malformation. The postoperative course was uneventful without recurrence at follow-up.

The diagnosis and treatment of cardiac lymphangioma

“…The symptoms of cardiac lymphangioma appear only when the tumor size becomes large enough. Among the 14 cases, arrhythmia was observed in 4 cases, [7,8,12,19] chest tightness and dyspnea in 4 cases, [14,15,18] chest pain in 2 cases, [17] and heart failure in 1 case [16] ; 2 cases were asymptomatic. [10,13] Results of laboratory examinations are generally normal.…”

“…[8] Cardiac lymphangioma can originate from various parts of the heart, including the atrial septum, myocardium, atrioventricular node, and heart valves. Of 14 cases, cardiac lymphangioma originated from the atrial septum in 3 cases [13,16] ; from the left ventricular myocardium in 3 cases [10,12,17] ; from the right atrium in 2 cases [7,15] ; from the left atrium in 1 case [9] ; from the right atrial sulcus in 1 case; [19] from the right ventricle in 1 case, [18] from the mitral valve in 1 case [11] ; from the tricuspid valve in 1 case [14] ; and from the atrial septum and right atrium in 1 case. [8] The symptoms of cardiac lymphangioma appear only when the tumor size becomes large enough.…”

The Value of Fetal Heart Evaluation in Fetuses with Rare Congenital Lymphangiomas: A Cohort Study from a Single Tertiary Center across Two Decades (Years 1999–2020)

“…Up to date, no extensive research has been carried out on this subject. Several echocardiographic examinations in a fetus with lymphangioma allowed for the observation of the lesion and analysis of whether the lymphatic lesion affects cardiac function, e.g., due to compression or flow and cardiac output disturbances [8,23]. In addition, fetal heart echocardiography in the third trimester of pregnancy in a fetus with an extracardiac defect allows us to indicate the time, place, and manner of delivery.…”

Incidental cardiac lymphangioma misdiagnosed as atrial thrombus: A case report

“…Cardiac lymphangioma, benign in nature, is an exceptionally rare primary neoplasm of the heart, with only a handful of cases reported in the literature [1] . While it may be clinically asymptomatic, various symptoms, ranging from mere arrhythmia to chest pain, valvulopathy, or heart failure, have been described [2] , [3] , [4] , [5] . Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are commonly utilized to discern and outline the suspected pathology [ 1 , 2 ].…”