Intramuscular cardiac hemangiomas are extremely rare. We describe a 74-year-old man with a tumor occupying the apex of the right ventricle that was incidentally diagnosed by echocardiography. Computed tomography and coronary angiography showed that the tumor arose from the ventricular septum and that the feeding artery was a branch of the right coronary artery. The tumor was completely excised, and the postoperative course was uneventful. Histological examination revealed that the tumor was a cardiac hemangioma (intramuscular type). To our knowledge, this is only the second case report of an intramuscular cardiac hemangioma in the world literature.

A pedunculated left ventricular hemangioma initially misdiagnosed as thrombus in a woman with atypical chest pain.J Thromb Thrombolysis. 2008 Feb 5.

The incidence of cardiac masses increased as echocardiography is becoming increasingly popular. Benign tumors of the heart constitute about 72% of all primary cardiac neoplasms and hemangioma accounts for 5-10% of benign cardiac tumors. Cardiac hemangiomas are generally asymptomatic and diagnosed incidentally during echocardiography or magnetic resonance imaging (MRI). We reported a 52-year-old woman presented with atypical chest pain and exertional dyspnea. The echocardiographic examination revealed a hyperechoic round mass in the left ventricle. With an initial diagnosis of left ventricular thrombus, the patient underwent cardiac MRI. The mass was found compatible with cardiac hemangioma. It was removed surgically and histopathologic evaluation identified a cardiac hemangioma. As reports of cardiac hemangioma are extremely rare and cardiac masses are mostly thought to be thrombi or myxomas (being the most common primary cardiac tumor), such hemangioma cases warrant attention as possibility of hemangioma should also be kept in mind.

Diagnostic features of cardiac hemangioma on cardiovascular magnetic resonance, a case report.Int J Cardiovasc Imaging. 2006 Oct;22(5):699-702. Epub 2006 May 17.

Cardiac hemangiomas are benign cardiac tumors that account for 5-10% of all benign tumors of the heart (Grebenc ML, Rosado de Christenson ML, Burke AP, Green CE, Galvin JR. Radiographics 2000; 20(4): 1073-1103). They occur in any cardiac location, including the pericardium (Brodwater B, Erasmus J, McAdams HP, Dodd L. J Comput Assist Tomogr 1996; 20(6): 954-956). Magnetic resonance imaging (MRI) has an excellent contrast resolution and multiplanar capability to allow optimal evaluation of myocardial infiltration, pericardial involvement and/or extracardiac extension (Brown JI, Barakos JA, Higgins CB. J Thorac Imaging 1989; 4(2): 58-64). This is a case report of cardiac hemangioma involving the ventricular septum with radiological and pathological correlation. It illustrates the capability of the MRI to non-invasively detect histological and flow characteristics of the tumor.