Cardiac Hemangioma Arising in the Epicardium

Abstract

A 32-year-old housewife was treated for recurrent pericardial effusion with repeated pericardiocentesis and pleuropericardial window formation after a diagnosis of tuberculous pericarditis. The biopsied pericardium revealed nonspecific inflammation. In spite of continuing antituberculosis medication, she did not improve and the pericardial effusion increased with emerging signs of progressive right heart failure. A pericardiectomy was performed and multiple masses with a cobblestone appearance were found on the entire epicardium and the great vessels. The partially excised masses showed mesothelial hyperplasia and capillary hemangioma. The pericardial effusion continued and radiation therapy (2,000 cGy/2 weeks) was given with corticosteroid to control immune thrombocytopenic purpura. On the 87th postoperative day, a left posterolateral thoracotomy was performed to remove a large pleural hematoma which was compressing the left atrium and the left ventricle. We found extensive spread of the hemangioma into the pleural cavity along the intercostal vessels. The patient died 3 days later from massive uncontrollable hemorrhage.