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A right atrial hemangioma mimicking thrombus in a patient with atrial arrhythmias.

Alpesh A P, Ebere O C, Daniel S S, Vivek B, Stuart O S, Anastasia A, Aasha S G - Open Cardiovasc Med J (2007)

Bottom Line: Cardiac hemangiomas are rare tumors, accounting for only 2.8% of all benign primary cardiac tumors and occur at any age.Clinical presentations vary depending on the tumor location (myocardial, endocardial or pericardial).In many cases, this may be an incidental finding.

View Article: PubMed Central - PubMed

Affiliation: Adult Noninvasive Laboratory, St. Francis Hospital, Roslyn, NY, Stony Brook University, Stony Brook, NY, USA.

ABSTRACT
Cardiac hemangiomas are rare tumors, accounting for only 2.8% of all benign primary cardiac tumors and occur at any age. Clinical presentations vary depending on the tumor location (myocardial, endocardial or pericardial). In many cases, this may be an incidental finding. We report the case of a patient with paroxysmal atrial fibrillation who had a right atrial hemangioma detected with transesophageal echocardiography prior to having percutaneous pulmonary vein isolation performed.

No MeSH data available.


Related in: MedlinePlus

Pedunculated and polypoid gross specimen.
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Figure 2: Pedunculated and polypoid gross specimen.

Mentions: A 50-year-old male with history of paroxysmal atrial fibrillation for one year presented for evaluation for pulmonary vein isolation. He had a history of palpitations, but denied syncope, chest pain, or dyspnea. Physical examination was unremarkable except for an irregular heart rate (approximately 90 beats per minute). Computed Tomographic Angiography (CTA) of the pulmonary veins and left atrium was normal. However, a large mass was noted in the right atrium. A presumptive diagnosis of tumor or a large thrombus was made. Transesophageal Echocardiography (TEE) revealed normal cardiac chamber sizes and normal left and right ventricular systolic function. A mobile mass measuring approximately 2.5 x 3.5 cm was identified (Fig. 1). The mass was cystic with septations and was attached to the interatrial septum near the inferior vena cava. Cardiac angiography revealed normal coronaries. The patient underwent open heart surgery to resect the mass and had intra-operative pulmonary vein isolation performed. The mass on gross examination was pedunculated and polypoid (Fig. 2). On sectioning, the cut surface was hemorrhagic, friable and partially cystic. This led to the preliminary diagnosis of an atrial thrombus. Multiple microscopic sections reveal a fibrotic hemorrhagic stroma with dilated cavernous vessels and focal small capillary channels (Fig. 3). The mass was covered with endocardium. The final diagnosis was an intracavitary cardiac hemangioma (cavernous and capillary type) of the right atrium. The patient did well and was discharged home in sinus rhythm.


A right atrial hemangioma mimicking thrombus in a patient with atrial arrhythmias.

Alpesh A P, Ebere O C, Daniel S S, Vivek B, Stuart O S, Anastasia A, Aasha S G - Open Cardiovasc Med J (2007)

Pedunculated and polypoid gross specimen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2570566&req=5

Figure 2: Pedunculated and polypoid gross specimen.
Mentions: A 50-year-old male with history of paroxysmal atrial fibrillation for one year presented for evaluation for pulmonary vein isolation. He had a history of palpitations, but denied syncope, chest pain, or dyspnea. Physical examination was unremarkable except for an irregular heart rate (approximately 90 beats per minute). Computed Tomographic Angiography (CTA) of the pulmonary veins and left atrium was normal. However, a large mass was noted in the right atrium. A presumptive diagnosis of tumor or a large thrombus was made. Transesophageal Echocardiography (TEE) revealed normal cardiac chamber sizes and normal left and right ventricular systolic function. A mobile mass measuring approximately 2.5 x 3.5 cm was identified (Fig. 1). The mass was cystic with septations and was attached to the interatrial septum near the inferior vena cava. Cardiac angiography revealed normal coronaries. The patient underwent open heart surgery to resect the mass and had intra-operative pulmonary vein isolation performed. The mass on gross examination was pedunculated and polypoid (Fig. 2). On sectioning, the cut surface was hemorrhagic, friable and partially cystic. This led to the preliminary diagnosis of an atrial thrombus. Multiple microscopic sections reveal a fibrotic hemorrhagic stroma with dilated cavernous vessels and focal small capillary channels (Fig. 3). The mass was covered with endocardium. The final diagnosis was an intracavitary cardiac hemangioma (cavernous and capillary type) of the right atrium. The patient did well and was discharged home in sinus rhythm.

Bottom Line: Cardiac hemangiomas are rare tumors, accounting for only 2.8% of all benign primary cardiac tumors and occur at any age.Clinical presentations vary depending on the tumor location (myocardial, endocardial or pericardial).In many cases, this may be an incidental finding.

View Article: PubMed Central - PubMed

Affiliation: Adult Noninvasive Laboratory, St. Francis Hospital, Roslyn, NY, Stony Brook University, Stony Brook, NY, USA.

ABSTRACT
Cardiac hemangiomas are rare tumors, accounting for only 2.8% of all benign primary cardiac tumors and occur at any age. Clinical presentations vary depending on the tumor location (myocardial, endocardial or pericardial). In many cases, this may be an incidental finding. We report the case of a patient with paroxysmal atrial fibrillation who had a right atrial hemangioma detected with transesophageal echocardiography prior to having percutaneous pulmonary vein isolation performed.

No MeSH data available.


Related in: MedlinePlus