Neonatal cardiogenic shock revealing obstructive cardiac Hibernoma: case report

Gribaa, Rym; Kacem, M.; Ouannes, Sami; Majdoub, Wiem; Thabet, Houssem; Ali, Imen Ben; Elheraiche, Aymen; Slim, Mehdi; Hmissa, Sihem; Neffati, E.; Cherif, Taieb; Kortas, Chokri; Jamli, Marah; Jerbi, S.

doi:10.1186/s13019-021-01582-z

Cited by 1 publication

(1 citation statement)

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“… 4–11 Currently, there are insufficient past cases of cardiac hibernoma to provide a thorough understanding of natural history. Fatal pulmonary embolism has been reported in an elderly woman, 10 as well as fatal cardiogenic shock in a neonate, 5 both of which were diagnosed post-mortem. More broadly, cardiac lipomas may be asymptomatic or present with symptoms of chest pain, dyspnoea, and palpitations to severe rare adverse events including syncope or sudden death secondary to arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

Hibernoma: a case report of a rare cardiac tumour

Cistulli,

Othman,

Karim

et al. 2023

European Heart Journal - Case Reports

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Background A cardiac hibernoma is a rare phenomenon, with just a handful of reports in the literature. They are difficult to characterise with conventional imaging including echocardiography, computed tomography (CT), cardiac magnetic resonance (CMR) or positron emission tomography (PET). Their definitive diagnosis relies primarily on histopathology via either endovascular or surgical biopsy. Previous case reports have entailed surgical excision followed by histopathology, however surgery may be unfavourable in some patients with increased perioperative risk. Case presentation We present the case of a 57-year-old woman who was referred to our Cardiology service with an inter-atrial lipomatous mass found incidentally on chest CT for assessment of rib fractures. She had 6 months of unexplained syncope, which was attributed to superior vena cava compression demonstrated by chest CT. The mass had benign characteristics on echocardiography, CT and CMR, however was glucose-avid on PET, which indicated a possible malignancy such as liposarcoma. Her comorbid and very significant airways disease precluded her from surgical excision, so instead endovascular biopsy was performed. Histopathology showed brown fat which was negative for mouse double minute 2 (MDM2) amplification on fluorescence in situ hybridisation (FISH) testing, hence a diagnosis was made of hibernoma, a rare benign tumour of brown fat. Given the benign diagnosis and her surgical risk with severe chronic obstructive pulmonary disease, a multidisciplinary recommendation was made favouring conservative management, with careful ongoing follow-up and the consideration of superior vena cava stenting if symptoms progressed. Discussion The definitive diagnosis of a cardiac hibernoma is complex and relies heavily on histopathology due to the contradictory findings on chest imaging. Careful consideration of management within a multidisciplinary team setting is essential to achieve a successful outcome.

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Section: Discussionmentioning

confidence: 99%