Super large cardiac hemangioma in right atrium and inferior vena cava: case report

Abstract

BackgroundCardiac hemangiomas are rare cardiac neoplasia usually diagnosed in autopsies, from being asymptomatic to debuting with sudden death. The largest hemangioma published in the literature is of 130 mm size, we present the following case of a successful cardiac hemangioma excision of 280 × 35 mm in size, diagnosed due to recurrent cardiac symptoms.Case presentationA 48-year-old female patient, Jehovah’s Witness, with no previous diagnoses, is admitted due to recurrent syncopal episodes in the previous months. A transthoracic echocardiogram diagnosed a tumor in the right atrium and inferior vena cava producing a diastolic right ventricular, with preservation of the left ventricular ejection fraction at 55%. Given the high mortality risk, a surgical intervention was performed immediately. Successful excision was completed confirming a 280 × 35 mm mass without any complications, consistent with hemangioma on histopathology. Postoperative recovery showed no recurrence or complications.ConclusionsCardiac hemangiomas are rare and its clinical course can be varied from patient to patient. We present excision of a large cardiac mass with a high mortality risk due to its size and the patient’s spiritual beliefs.

Unexpected diagnosis: large hemangioma in the interatrial septum

“…Cardiac hemangiomas are rare primary tumors, accounting for approximately 1–2% of primary cardiac tumors [ 1 ]. These tumors can occur at any age and in any location, but they are mostly found in the left atrium and left ventricle, and extremely rare in the IAS, as in the case we present [ 2 ].…”

“…Cardiac hemangiomas are very rare benign primary tumors [ 1 ]. Most of the time, they are incidental findings during autopsies or routine examinations.…”

Surgical resection for a huge right ventricular hemangioma

“…The cavernous subtype is characterized by multiple thin or thick-walled dilated vessels; the capillary subtype consists of lobules of endothelial cells forming small, capillary-like vessels; the arteriovenous subtype is composed of dysplastic thick-walled arterioles, venous-like vessels, and capillaries. [4] The postoperative prognosis is usually excellent in patients with resectable tumors, but periodic echocardiography is nevertheless recommended to survey for recurrence of tumor growth.…”