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HERDIN Record #: PCHRD090107030912 Submitted: 02 September 2007 Modified: 03 October 2017

Cardiac hemangioma presenting right ventricular outflow tract mass.

Geraldine Yap,
Bernadette Asuncion,
George  Tamayo,
Donaldson Gadingan,
Darwin O. Misa

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- Cardiac hemangiomas are exceptionally rare tumors with an incidence of 1 % to 2% of all detected benign heart neoplasms. Obstruction of the right ventricular outflow tract (RVOT) by a primary cardiac tumor is even rarer. To date, eleven cases of RVOT obstruction by a primary cardiac hemangioma have been reported and this is the first case in our institution. We report a case of a 3 5-year-old female presented at our institution with the chief complaint of progressive easy fatigability and exertional dyspnea of 4 months duration with grade 3/6 systolic murmur at 2nd to 4th ICS left parasternal area. Chest X-ray showed normal size heart with bulging of the left median curve. Echocardiography (ECG) showed sinus rhythm with septal wall ischemia. Transthoracic and transesophageal echocardiography confirmed the presence of an inhomogenous, irregularly shaped, confluent, mobile, lobulated mass in the right ventricular outflow tract before the pulmonic valve attached to the proximal interventricular septum. On computed tomo-graphic (CT) scan of the chest, a dilated and tortous enhancing structures along the groove of the interventricular septum which is intimately related to the dilated pulmonary artery was noted. An angiography was contemplated but it was deferred since the initial consideration was a myxoma.

The patient underwent elective excision of the cardiac mass. Grossly, the heart was noted to have dilated coronary arteries. On operation, arteriovenous malformation was noted just below the pulmonic valve attached to the septal wall. Excision and antero-ligation of the arteriovenous malformation was done. On histologic examination, the specimen consisted of several irregular fragments of tan-white, soft tissues altogether measuring 4x4x1 cm. Microsections showed fibrocollagenous tissue with variably sized vascular channels lined by a single layer of endothelium with some areas exhibiting calcification. Conclusion was vascular malformation consistent with cardiac hemangioma. The postoperative course was uneventful and the patient was discharged on the 10th postoperative day. (Author)

Publication Type
Journal
Publication Sub Type
Case report
Title
Philippine Heart Center Journal
Frequency
Quarterly
Publication Date
January-March 2006
Volume
12
Issue
1
Page(s)
56-58

Objectives

1. To present a rare case of cardiac hemangioma presenting as right ventricular outflow tract mass.

2. To discuss the presentation, diagnosis, and management of cardiac hemangioma.

LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)
Philippine Heart Center Medical Library CR.013.05 Fulltext Print Format (Request Document)
 

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