2016, Number 3
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Rev Med Inst Mex Seguro Soc 2016; 54 (3)
Primary cardiac hemangioendothelioma: early diagnosis and surgical resection
Gaytán-Cortés FC, Arteaga-Adame J, Careaga-Reyna G, Lezama-Urtecho C, Álvarez-Sánchez L
Language: Spanish
References: 18
Page: 392-396
PDF size: 606.59 Kb.
ABSTRACT
Background: The term hemangioendothelioma encompasses all tumors
that derive from the endothelium of blood vessels. It has an uncertain
prognosis, and it is always considered as a low-grade malignancy.
Clinical case: Male, 23, who was admitted to the emergency room with
chest pain, intermittent paroxysmal nocturnal dyspnea and malaise. He
denied having a history of degenerative diseases, and had a weight loss
of 6 kg in two months. Chest X-rays suggested pericardial effusion. Patient
presented a tendency to hypotension tamponade, which was solved with
subxiphoid puncture, and drain 800 mL of liquid from ancient hematological
parameters. He presented a tumor in the right atrium of 8 x 4 cm,
attached to the anterior wall of the atrium without involucre of interatrial
septum. When patient underwent surgery, it was identified a tumor lesion
in the anterior wall of right appendage. It was done the resection of the
tumor and of 70 % of the right atrial appendage. The latter was replaced
with bovine pericardium. Patient showed good outcome; it was discharged
after 10 days of follow-up surgery for six months in the outpatient clinic.
Conclusion: The hemangioendothelioma is a vascular tumor of unpredictable
behavior, and whose origin rarely comes from the heart. A timely
detection, and a radical surgical resection is, so far, the more acceptable
management, given the worldwide little experience for handling this type
of tumor. Our experience suggests an aggressive clinical approach and
surgical removal within the first hours of the suspected diagnosis for the
greatest chance of complete resection and reducing the risk of recurrence.
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