Organized Hemopericardium Mimicking Malignant Tumor: A Case of Spontaneous Pericardial Hematoma In a 23-Year-Old Young Male

Abstract

Spontaneous pericardial hematoma is rare, and the diagnosis of spontaneous organized hemopericardium is difficult in some cases. The present study reports a case of a 23-year-old man admitted to our hospital for dyspnea on Sept. 30, 2017. The patient experienced shortness of breath 10 days before admission and went to a local hospital. The chest non-contrast CT and Echo revealed effusion of pericardium, right thoracic cavity and abdominal cavity. The patient went to our hospital for further treatment, and there was no abnormality in the laboratory tests of infection, tumor, or immune disease. The patient received pericardiocentesis for cardiac tamponade. A re-examination of Echo after pericardiocentesis revealed a pericardial mass. The enhanced chest CT and 18F-FDG PET/CT could not rule out the risk of a malignant tumor. The resection of pericardial mass was performed under cardiopulmonary bypass with cardioplegia. The pathology was organized hematoma with widely hemorrhage and necrosis, fibrous tissue proliferation, myofibroblast proliferation, and granulation tissue formation. The patient was discharged from our hospital without recurrence of pericardial effusion or the symptom of dyspnea. This case suggests that spontaneous organized hemopericardium is difficult to be distinguished from malignant tumor, and a surgical resection can help with diagnosis and symptomatic relief.