Seitz Andreas, Ong Peter, Backes Maik, Mahrholdt Heiko
Department of Cardiology, Robert Bosch Medical Center, Auerbachstr. 110, 70376 Stuttgart, Germany.
Department of Radiology, Robert Bosch Medical Center, Auerbachstr. 110, 70376 Stuttgart, Germany.
Eur Heart J Case Rep. 2018 Mar 6;2(1):yty024. doi: 10.1093/ehjcr/yty024. eCollection 2018 Mar.
Cardiac haemangiomas are rare vascular tumours of the heart accounting for less than 5% of benign primary cardiac neoplasms. They are sometimes diagnosed incidentally, since patients can be asymptomatic. The clinical presentation in symptomatic patients, however, is variable, depending on size and exact localization of the tumour. Although cardiac haemangiomas have been reported everywhere in the heart, those localized in the pericardium are extremely rare.
A 48-year-old female patient with a history of pericardial effusion and pneumonia was admitted to our hospital with progressive dyspnoea on exertion. Echocardiography demonstrated recurrence of pericardial effusion with 'swinging heart'. Further investigation by computed tomography, cardiac magnetic resonance imaging and coronary angiography revealed a hypervascular pericardial mass with typical 'tumour blush' after contrast injection. The tumour could be resected by open heart surgery, and histological evaluation confirmed the diagnosis of a pericardial capillary haemangioma. There were no signs of recurrence of neither the pericardial effusion nor the tumour during follow-up.
We here report a very rare case of a pericardial haemangioma in the adult which was diagnosed by multi-modality workup of recurrent pericardial effusion. This case illustrates that in the setting of chronic pericardial effusion non-inflammatory and non-malignant causes should be taken into account.
心脏血管瘤是罕见的心脏血管肿瘤，占原发性心脏良性肿瘤的比例不到5%。它们有时是偶然被诊断出来的，因为患者可能没有症状。然而，有症状患者的临床表现则各不相同，这取决于肿瘤的大小和确切位置。虽然心脏血管瘤在心脏各处都有报道，但位于心包的极为罕见。
一名48岁女性患者，有心包积液和肺炎病史，因进行性劳力性呼吸困难入住我院。超声心动图显示心包积液复发伴“心脏摆动”。计算机断层扫描、心脏磁共振成像和冠状动脉造影进一步检查发现，注射造影剂后有一个高血运的心包肿块，伴有典型的“肿瘤染色”。该肿瘤可通过心脏直视手术切除，组织学评估确诊为心包毛细血管瘤。随访期间，心包积液和肿瘤均无复发迹象。
我们在此报告一例非常罕见的成人心包血管瘤病例，该病例通过对复发性心包积液的多模态检查得以诊断。该病例表明，在慢性心包积液的情况下，应考虑非炎症性和非恶性病因。
