KEYWORDS
cardiac hemangioma, cardiac primary tumor, transthoracic echocardiography
A 67-year-old female patient with a 8-month history of sigmoid colon cancer resection was readmitted to our hospital due to routine follow-up. The presurgical transthoracic echocardiography (TTE) result was unremarkable (Figure 1A).
The TTE examination revealed that the right atrium (RA) had a hypoechoic neoplasm, about 4.3x3.8 cm, round, clear boundary, hyperechoic capsule, and attached to the wall (Figure 1B). The neoplasm broke into the tricuspid valve during diastole and returned to the RA during systole, leading to moderate regurgitation of the tricuspid valve during systole (Figure2; Videoclip S1). The marked hypoechogenicity and hyperechoic capsule may be the characteristic of cardiac hemangioma, which are related to thrombus and blood clots formed in the vascular lumen, and complete envelope1-3.Contrast-enhanced computerized tomography (CT) of the chest showed low-density masses with slight enhancement in the RA (Figure 3).
Surgical clipping of the atrial tumor was performed. The excised specimen was dark red in color and had a complete envelope. Histopathological examination showed tissue with benign endothelial cells and large communicating lumens consistent with a cavernous hemangioma (Figure 4). The subsequent recovery were uncomplicated and the patient was discharged 1 weeks after the operation.