CONGRESS ABSTRACT

INTRODUCTION: Primitive cardiac neoplasms are rare and usually diagnosed after death, mainly due to the nonspecificity of signs and symptoms. Among the benign cardiac tumors, cavernous angiomas represent the 2.8%. The appearance goes from childhood to adulthood. Symptoms can vary according to the localization, dimensions and the cardiac structures involved. CLINICAL CASE: A 59-year-old hypertensive, dyslipidemic, diabetic, ex-smoker woman comes to our emergency department for exertional dyspnea in the suspect of pulmonary embolism. A chest CT scan just showed right intraauricular thrombosis without pulmonary embolism. Anticoagulant therapy and genetic examination for thrombophilia were started. After a month, a cardiac MRI confirmed the suspicion of thrombotic material in the organizing phase described as right atrial formation with axial diameters of 3 cm x 2 cm and longitudinal diameter of 3,8 cm, impressing the SVC ostium, marked high intensity on T2- weighted and infiltrated by contrast. In the following month, the patient was hospitalized again due to worsening of the dyspnea and nocturnal chest pain. Coronary angiography showed sub-occlusive stenosis of the mid-proximal AIV and 80% stenosis of the 1st mid-diagonal branch. A transthoracic-transesophageal echocardiography study confirmed that the mass protrudes into the right atrium up to orifice of the inferior cava(30 x 40 mm) and for the first time has highlighted regular margins with hyperechogenicity of the surface compatible with the thin capsule. A uniform content, without signs of pulsatile vascularization, and a hypoechoic portion of 11 x 10 mm at the level of the implant base, surrounded by thin intralesional sedimentation, was described. In the suspicion of angioma, cardiac surgery consultation was requested, which confirmed the diagnosis and put the patient to surgery. Histopathological examination confirmed cardiac cavernous hemangioma. CONCLUSIONS: The integration of surface echocardiographic findings with CT and MRI data of the prevalent blood component has led to a correct diagnosis and therapeutic management. Surgical excision of cardiac hemangioma is recommended for resectable tumor and is considered curative in most cases.