Cardiac hemangioma at the apex of the right ventricle: a case report and literature review

Multiple Right Ventricular Haemangiomas

Right ventricular haemangiomas are rare benign tumours, usually solitary and commonly located in the right heart. We report a 49-year-old female who presented with four masses in the right ventricle, three arising from the right ventricular free wall and one arising from the anterior leaflet of the tricuspid valve. She subsequently underwent total excision of the tumours and an anteroinferior commissuroplasty for severe tricuspid regurgitation complicating the excision. Histology confirmed cavernous haemangioma. Solitary haemangioma of the right ventricle has been reported severally in the literature but, to the best of our knowledge, this is the first report of multiple right ventricular haemangiomas.

A Rare Cardiac Cavernous Hemangioma Treated with Radiotherapy

Background

Although cardiac hemangiomas, as rare benign cardiac tumors, have been described in previous case reports, the role of radiation therapy in an unresectable cardiac hemangioma in adult has not been reported. We present a case report of a rare unresectable cardiac cavernous hemangioma treated with radiotherapy. Case Presentation. A 45-year-old female with new onset of coughing and worsening shortness of breath was found to have a biopsy proven cardiac cavernous hemangioma. Surgery was aborted due to excessive bleeding, and she was then treated with radiotherapy. A total dose of 30 Gy in 15 fractions was given using intensity-modulated radiation therapy (IMRT) to the mass with a modified 1 cm margin. Complete clinical symptomatic relief was achieved with reduction of the mass posttreatment. Ten-year follow-up revealed a stable, reduced hemangioma with no recurrence of symptoms.

Conclusions

This is a rare example of cardiac hemangioma that developed in the right ventricle and compressed several major vessels. Radiotherapy may be safely used for treatment of unresectable cardiac hemangioma.

Diagnostic mystery-a rare right ventricular cardiac hemangioma: a case report

BACKGROUND

Cardiac hemangiomas are rare in all kinds of benign cardiac tumors. Although cardiac hemangiomas affect all ages and may occur anywhere within the heart, right ventricular hemangiomas are extremely uncommon.

CASE PRESENTATION

We report a 56-year-old woman presented with chest tightness and breath shortness for 3 months. Transthoracic echocardiography and coronary computed tomography angiography showed a mass located adjacent to the apex of the right ventricle but both failed to figure out where the mass originated from, remaining a diagnostic mystery preoperatively. The mass was removed successfully and the histopathological examination confirmed it was hemangioma.

CONCLUSIONS

Cardiac magnetic resonance should be the ultimate diagnostic tool of cardiac tumors. Surgical removal, associated with a low recurrence rate and long-term survival benefits, should be the first choice of therapy for cardiac hemangiomas.

Right ventricular haemangioma as a rare cause of chest pain: a case report

Background

Cardiac haemangioma is a rare primary cardiac tumour. Most patients with cardiac haemangioma have no typical symptoms, and some may present with non-specific manifestations, such as shortness of breath, heart palpitations, or cardiac insufficiency, making it difficult to distinguish cardiac haemangioma from other diseases. We report a case of cardiac haemangioma that present with chest pain. This haemangioma was finally completely excised to relieve the patient’s symptoms and a avoid poor prognosis.

Case summary

A 14-year-old boy presented with an intermittent and progressive non-exertional chest pain for 2 weeks. Echocardiography showed a space-occupying mass at the right ventricular apex, which was later confirmed by computed tomography angiography and magnetic resonance imaging (MRI). The mass was successfully resected, and postoperative pathology confirmed a cardiac cavernous haemangioma. The patient had an uneventful postoperative recovery at the 8-month follow-up.

Discussion

Cardiac haemangioma is a benign tumour with no typical clinical manifestations, and very few patients may present with chest pain. Preoperative echocardiography, computed tomography, and MRI are helpful for diagnosis, and surgery can relieve symptoms and may improve the prognosis of patients with cardiac haemangioma.

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

Background

Cardiac 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 presentation

A 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.

Conclusions

Cardiac 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.

Incidental finding of a giant intracardiac angioma infiltrating both ventricles in a 35-year-old woman: a case report

Background

Primary cardiac tumors are rare and often asymptomatic or present with unspecific symptoms. Benign cardiac tumors of vascular origin are especially rare, with only few existing data in the literature.

Case presentation

A 35-year-old Caucasian female patient presented to our department with an asymptomatic giant intracardiac angioma infiltrating both ventricles. Evaluation of this tumor involved electrocardiography, echocardiography, cardiac magnetic resonance imaging, coronary angiography, an open myocardial biopsy, and histological examination of the resected specimen. Because our patient was asymptomatic, she was managed conservatively with regular follow-up. We discuss the treatment options available in comparison with similar cases.

Conclusion

Diagnosis and therapy of benign cardiac tumors, especially of asymptomatic lesions, can be a challenge. There is no evidence available to help in the management of such patients. An extensive evaluation is needed with different imaging modalities, and case-specific decisions should be made that involve experts in cardiology, cardio-oncology, and heart surgery.

Electronic supplementary material

The online version of this article (doi:10.1186/s13256-016-0860-4) contains supplementary material, which is available to authorized users.