Intrapericardial lymphangioma presenting as neonatal cardiac tamponade

Abstract

We report a unique case of cardiac tamponade in a newborn due to an intrapericardial lymphangioma. Echocardiography and magnetic resonance imaging suggested that the mass, which was situated between the right atrium and the aortic root, was unsuitable for primary resection. A pericardial window was performed, and over the next 16 months the tumor spontaneously regressed.

A Case of Cardiac Lymphangioma Presenting as a Cystic Mass in the Right Atrium

“…Only nine cases of cardiac lymphangioma have been reported in the medical literature 3-11. More than half of the reported cases have occurred in patients under 10 years of age 3,4,6,8,9,11. Mediastinal lymphangiomas are most often asymptomatic masses incidentally discovered on chest X-ray.…”

“…Mediastinal lymphangiomas are most often asymptomatic masses incidentally discovered on chest X-ray. However, cardiac lymphangiomas are commonly revealed during congestive heart failure, syncopal or embolic pathology, arrhythmias, palpitations, or cardiac tamponade 3,4,7,9,10,12…”

Imaging of pericardial lymphangioma

“…Although first described in 1911 by Armstrong and Monkeberg, only a few cases are described in the literature[1] . The armed force registry of benign cardiac tumors in children only found 2 cases in 319 cases of benign tumors and cysts of pericardium,[2] and an European multicentric study of tumors in children did not find any cardiac lymphangiomas. [4] Araoz et al .,[3] reviewed the pathology and imaging features of benign cardiac tumors including lymphangioma.…”

“…However, they may cause congestive heart failure, syncopal or embolic pathology, arrhythmias, palpitations, or cardiac tamponade. [12] Majority of symptoms are accredited to their size and location. In our case, the size of the neoplasm may have caused compression of the anatomical structures adjacent to it causing symptoms of respiratory distress.…”

“…[12] Cardiac lymphangiomas most frequently occur in the pericardial space, sometimes compressing adjacent structures;[3] a chylous pericardial effusion may also be present. [2] To the best of our knowledge, only nine cases have been reported in the medical literature[1]. We report a case of isolated pericardial lymphangioma in a 1-year-old child.…”