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2015-09-20-15 Answer to the case of the week #404 © Tsikhanenka www.TheFetus.net 


Answer to the case of the week #404


September 24, 2015 - October 8, 2015

Irina Tsikhanenka
, MD, PhD1, Deilidka E., MD2, Korolkova E., MD3, Dedovich V., MD, PhD3, Boiko M, MD4

  1. Prenatal ultrasound diagnostic center, 1st Minsk Clinic Hospital, Minsk, Belarus.
  2. Prenatal ultrasound diagnostic center, 2d Minsk Clinic Maternity Hospital, Minsk, Belarus.
  3. Republican Scientific and Practical Center of Pediatric Surgery, Minsk, Belarus.
  4. City Clinical Pathologic Anatomy Bureau, Minsk.
Case report

Following images and videos show a case of cavernous papillary hemangioma of the heart that was seen in our office at 33+6 weeks and 37+3 weeks of otherwise uncomplicated gestation. Previous examinations at 12 and 20 weeks were reported to be normal and clinical history was unremarkable.

Our examination revealed an echogenic tumorous mass located in the right atrium of the heart and pericardial effusion. The heart and pericardial effusion were compressing the lung. Diagnosis of cardiac hemangioma or myxoma was suspected.

The male newborn was delivered by cesarean section at 37 weeks and 5 days and two days later underwent surgical removal of the cardiac tumor. Final histological diagnosis was cavernous papillary hemangioma with myxomatosis and thrombotic phenomenon. Postoperative course was uneventful.

33 weeks 6 days 

Images 1, 2, and 3: The images show an echogenic well-defined mass (18 x 18 mm) within the right atrium of the heart with almost no intra-tumorous vascularization and massive pericardial effusion.

 


37 weeks 3 days 

Images 4, 5 and 6, and videos 1, 2: The images show heterogeneous tumor in the posterior aspect of the right atrium of the heart. The size of the tumor was almost the same as during the previous scan at 34 weeks. Cardiac hemangioma or myxoma was suspected.

 



 

Images 7, 8, and 9:
 Normal great arteries, inferior vena cava and aortic arch can be seen. Pericardial effusion with left lung compression is present.

 



Images 10 and 11: Postnatal images obtained during surgical removal of the tumor. Histology showed diagnosis of cavernous papillary hemangioma.  





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