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Case report and literature review: cardiac hematic cyst.

ABSTRACT: A 49-year-old female patient, asymptomatic, presented to the cardiology office for a right atrial mass, identified incidentally in a non-electrocardiogram (ECG)-gated contrast-enhanced computed tomography, performed for follow-up of pulmonary tuberculosis. Echocardiography, surprisingly, showed an anechogenic ovoid mass in the right atrium measuring 40 × 40 mm², implanted in the interatrial septum without affecting the tricuspid valve. ECG-gated computed tomography angiography (CTA), confirmed the dimensions of the mass, which presented homogeneous content, calcified areas, and a 12-mm pedicle implanted near the ostium of the coronary sinus. Additionally, contrast uptake and infiltration of adjacent structures were ruled out. In the surgical field, an encapsulated mass with blood content was found, which pathology reported as a hematic endocardial cyst (HEC). These are rare cardiac masses, constituting 1.5% of all primary cardiac tumors. It is usually an incidental finding, and its clinical presentation will depend on its dimensions and the intracardiac hemodynamic impact. A highlighting feature is its anechogenic content on ultrasound, however, multimodality imaging allows for making diagnostic assumptions, discerning between primary cardiac tumors, and provides morphological and hemodynamic information useful for therapeutic decision making. The age of the patient, the large size of the HEC, and its location in the interatrial septum make up a completely atypical presentation of this rare disease, which motivated this report.

SUBMITTER: Baltodano-Arellano R

PROVIDER: S-EPMC11319172 | biostudies-literature | 2024

REPOSITORIES: biostudies-literature

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Case report and literature review: cardiac hematic cyst.

Baltodano-Arellano Roberto R Alvarez-Tiburcio Eduardo E Barriales-Revilla Lucia L Bellido-Yarlequé David D Cachicatari Angela A Cupe-Chacalcaje Kelly K La Torre-Zuñiga Alan A Velarde-Acosta Kevin K

Frontiers in cardiovascular medicine 20240730

A 49-year-old female patient, asymptomatic, presented to the cardiology office for a right atrial mass, identified incidentally in a non-electrocardiogram (ECG)-gated contrast-enhanced computed tomography, performed for follow-up of pulmonary tuberculosis. Echocardiography, surprisingly, showed an anechogenic ovoid mass in the right atrium measuring 40 × 40 mm<sup>2</sup>, implanted in the interatrial septum without affecting the tricuspid valve. ECG-gated computed tomography angiography (CTA), ...[more]

PMID: 39139751

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Project description:BackgroundEchinococcosis is a zoonotic parasitic disease prevalent in pastoral areas, mainly involving the liver and lungs, and rarely affecting the brain and heart. This article describes the diagnosis and treatment of 14 patients with cardiac encapsulated cysts, with the aim of providing insights into the clinical presentation, diagnostic challenges, therapeutic strategies, and outcomes associated with cardiac encapsulated cysts.MethodsThis retrospective case series included 13 patients with cardiac and/or cerebral encapsulated cysts.ResultsWe retrospectively analyzed 14 patients diagnosed with cardiac and pericardial echinococcosis between 2012 and 2024 at our hospital. The patients' average age was 26 years, ranging from 3 to 60 years. Echinococcal cysts were found in various cardiac locations, including the pericardium (5 patients), left ventricle (3 patients), right atrium (2 patients), and apical region of the heart (1 patient). Chest pain (6 patients) was a common symptom if the cyst was in the heart, dyspnea, or cough (3 patients) if it was in the lungs, and epilepsy (1 patient) if it was in the brain. Diagnosis of this condition necessitates the performance of both laboratory tests and imaging procedures. The latter requires the expertise of a trained professional to accurately differentiate between cardiac-encapsulated cysts and other types of cysts. All patients in our study were examined as described above. The recommended course of treatment is typically surgical removal of the cyst and administration of medications to prevent recurrence. In instances where the patient declines to surgery, it is advised that they be provided with medication and scheduled for regular follow-up appointments. In our study, data were lost for two patients. Eight patients underwent open-heart surgery, one underwent craniotomy for epilepsy, one underwent thoracentesis and drainage for pleural effusion, and one patient declined surgery.ConclusionsCardiac echinococcosis is common in pastoral populations, Surgical excision combined with pharmacological treatment is the best option for the treatment of cardiac echinococcosis.

Project description:IntroductionPericardial cysts are considered as a rare congenital abnormality, mostly found incidentally. The estimated incidence of pericardial cyst is 1:100,000 and represent approximately 6% of all mediastinal masses. Patients can present with symptoms similar to acute chest pain or right-sided heart failure or can be asymptomatic.PresentationA 46-year-old female who is known to have hypertension and hypothyroidism presented to the breast clinic with left breast mass that was proved by core needle biopsy as proliferative breast lesion. During the preoperative assessment, the patient reported progressive shortness of breath and cough over the last two years and bilateral lower limb edema. Her preoperative chest X-ray showed a well-defined oval like opacification at the right cardiophrenic angle that was proved by chest computed tomography imaging as a cystic mass od most likely a pericardial origin. A huge pericardial cyst originating from the right diaphragmatic surface was excised through a mini-sternotomy incision with smooth postoperative recovery. The patient-reported significant improvement in her symptoms and her lifestyle during her follow up.DiscussionPericardial cysts represent 6%-7% of all mediastinal masses with an estimated incidence of 1:100,000. About 70% of pericardial cysts originate at the right cardiophrenic angle and less frequently at the left cardiophrenic angle, they are usually suspected when the chest x-ray shows an enlarged contour of the right heart border. Mediastinal cysts have many differential diagnoses and the preoperative decision might be challenging in many cases. Pericardial cysts appear as oval, thin-walled homogeneous masses on cardiac computed tomography. The choice between surgical intervention and conservative follow up is related mainly to the size and symptoms that are induced by the cyst.ConclusionAs pericardial cysts are rarely diagnosed pathology, a high index of suspicion is essential for diagnosis. Surgical resection is indicated when they are huge, enlarging in size or symptomatic. Morbidity and mortality risks following pericardial cyst excision are very low.

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Case report and literature review: cardiac hematic cyst.

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Case report and literature review: cardiac hematic cyst.

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