Cardiac Hamartoma: A Diagnostic Challenge

Abu‐Zaid, Ahmed; Gakhal, Mandip; Montgomery, Eric; LaPoint, Randi; Horn, Robin; Banbury, Michael K.

doi:10.1016/j.case.2017.01.014

Cited by 6 publications

(8 citation statements)

References 7 publications

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“…Differentiating cardiac hamartomas from other masses such as HCM, thrombus, or malignant cardiac tumors can be challenging, as imaging findings are often nonspecific. On echocardiography, hamartomas are reported as hyperechoic intracavitary masses with predilection for the LV ( 3 , 4 ). On CMR, the appearance of a hamartoma ranges from mildly hypointense to hyperintense signal on T2-weighted images, and enhancement on early and delayed phase post-contrast images ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…On echocardiography, hamartomas are reported as hyperechoic intracavitary masses with predilection for the LV ( 3 , 4 ). On CMR, the appearance of a hamartoma ranges from mildly hypointense to hyperintense signal on T2-weighted images, and enhancement on early and delayed phase post-contrast images ( 4 ). CMR may exclude thrombus or malignant lesions by first pass and delayed contrast enhancement, and regional variation in vascularity ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…CMR may exclude thrombus or malignant lesions by first pass and delayed contrast enhancement, and regional variation in vascularity ( 3 ). Fluorodeoxyglucose positron emission tomography may also help differentiate benign from malignant lesions ( 4 ). Incisional biopsy may be inconclusive (as in this case), as the hamartoma tissue can be nonspecific and similar to the surrounding myocardium.…”

Section: Discussionmentioning

confidence: 99%

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A Case of Ventricular Tachycardia Caused by a Rare Cardiac Mesenchymal Hamartoma

et al. 2020

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The presentation of a cardiac hamartoma, an exceedingly rare and histologically benign cardiac tumor, can be variable. We describe a case of refractory ventricular tachycardia in a patient with a cardiac mass failing multiple pharmacologic and procedural interventions, ultimately treated by cardiac transplantation and diagnosed with a mesenchymal cardiac hamartoma. ( Level of Difficulty: Intermediate. )

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Case of Ventricular Tachycardia Caused by a Rare Cardiac Mesenchymal Hamartoma

et al. 2020

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“…However, since the morphology of HMCM varies and can be well circumscribed or infiltrated to normal myocardium, it is difficult to distinguish it from other cardiac lesions, such as fibroma, hypertrophic cardiomyopathy, or rhabdomyoma just by CMR. [3,12,15,16]…”

Section: Discussionmentioning

confidence: 99%

Hamartoma of mature cardiomyocytes in right atrium

Zhou¹,

Yuan²,

Zeng

et al. 2019

Medicine

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Rationale: Tumors in the heart are rare. Myxomas, rhabdomyomas, and fibromas are the most common benign cardiac tumors. Hamartoma of mature cardiomyocytes (HMCM) is another benign cardiac tumor, are very rare and have only been reported in a few literatures. Patient concerns: We report a case of 41-year-old male who suffered short of breath for 3 years, and lower limbs edema for 2 years. Diagnoses: Transthoracic echocardiogram (TTE) and cardiac magnetic resonance (CMR) showed a large amount of pericardial effusion and confirmed a mass of 18 × 14 mm on the superior vena cava near the outer edge of right atrium. The patient was first diagnosed as pleural mesothelioma. Surgery was performed to relieve the symptoms and confirm diagnoses. However, during surgery, we found the right atrium is apparently thicken with rough and uneven surface. Histology of right atrium mass indicated it as hamartoma of mature cardiomyocytes. Intervention: We resected the thicken atrial wall completely, reconstructed right atrium with bovine pericardial patch, and resected the pericardium. Outcomes: Patient was discharged 9 days after surgery, and remained asymptomatic during 9 months follow up. Lessons: Hamartoma of mature cardomyocytes is a rare benign cardiac tumor. There were 26 cases reported until now. The conclusive diagnosis depends on pathological sections. For patients with symptoms, surgery is an effective treatment for HMCM.

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“…Forty-seven relevant cases of cardiac hamartoma were identified in the literature between 1970 and 2020 (Table 1). 2,3,7,9,[12][13][14]16,17,[19][20][21][22]29 The patient's ages ranged from 4 weeks to 74 years of age. Of the 47 cases, 23 were in pediatric patients and 24 were in adult patients.…”

Section: Literature Reviewmentioning

confidence: 99%

A Rare Case of Cardiac Mesenchymal Hamartoma and Comprehensive Review of the Literature With Emphasis on Histopathology

et al. 2021

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Hamartomas are primary, benign neoplastic lesions that most commonly derive from a single variably differentiated cell lineage. Here, we report an unusual case of a cardiac hamartoma. A 62-year-old woman presented with chest pain and palpitations. Serial imaging revealed a large slowly growing and highly vascularized left ventricular mass, which required surgical resection. Microscopically, the lesion was composed of nodular fibrovascular proliferation with haphazardly embedded muscle bundles and peripheral calcifications. Immunohistochemical studies revealed prominent muscle-specific actin positive and smooth muscle actin positive muscle fiber bundles within a disorganized fibrovascular stroma. This characterization is most consistent with cardiac mesenchymal hamartoma. Relevant differential diagnoses for this lesion include hamartoma of mature cardiac myocytes (HMCMs) and intramuscular hemangioma. The prominent smooth muscle differentiation of muscle bundles was incompatible with defining features of HMCM. Absence of S100-positive nerve and mature adipose cells distinguished this lesion from the recently defined, heterogeneous cardiac mesenchymal hamartoma. Forty-seven cases of cardiac hamartoma reported from 1970 to 2020 were reviewed to provide histopathologic context.

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Cardiac Hamartoma: A Diagnostic Challenge

Abstract: Graphical abstract

Cited by 6 publications

References 7 publications

A Case of Ventricular Tachycardia Caused by a Rare Cardiac Mesenchymal Hamartoma

A Case of Ventricular Tachycardia Caused by a Rare Cardiac Mesenchymal Hamartoma

Hamartoma of mature cardiomyocytes in right atrium

A Rare Case of Cardiac Mesenchymal Hamartoma and Comprehensive Review of the Literature With Emphasis on Histopathology

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