Organized Hemopericardium Mimicking Malignant Tumor: A Case of Spontaneous Pericardial Hematoma In a 23-Year-Old Young Male
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.
Alter P, Figiel JH, Rupp TP, Bachmann GF, Maisch B, et al. 2013. MR, CT, and PET imaging in pericardial disease. Heart Fail Rev. 18(3):289-306.
Chamsi-Pasha MA, Anwar AM, Nosir YF, Ajam A, Abukhudair W, et al. 2011. Organized intrapericardial haematoma: a rare cause of heart failure after 2 years of trauma. Eur J Echocardiogr. 12(1):E1.
Cordes D, DeGroff C, Shaffer EM. 1999. Spontaneous pericardial hematoma in an infant. Pediatr Cardiol. 20(5):380-1.
Maksimović R, Dill T, Seferović PM, Ristić AD, Alter P, et al. 2006. Magnetic resonance imaging in pericardial diseases. Indications and diagnostic value. Herz. 31(7):708-14.
Nakanishi N, Sawada T, Sato R, Yanishi K, Akakabe Y, et al. 2009. Spontaneous pericardial hematoma with familial amyloid polyneuropathy. Amyloid. 16(4):221-5.
Sughiura T, Nishida H, Ishitoya H, Tomizawa Y, Saito S, et al. 2006. Chronic expanding intrapericardial hematoma after pericardial paracentesis. J Card Surg. 21(5):491-3.
Tokue H, Tokue A, Okauchi K, Tsushima Y. 2013. 2-[18F]fluoro-2-deoxy-D-glucose (FDG) positronemission tomography (PET) findings of chronic expanding intrapericardial hematoma: a potential interpretive pitfall that mimics a malignant tumor. J Cardiothorac Surg. 8:13.
Ueyama K, Morishima M, Iida J. 2015. First report of chronic expanding intrapericardial hematoma caused by coronary to pulmonary artery fistulas. Ann Thorac Surg. 99(3):1084.
Velibey Y, Sahin S, Altay S, Bakshaliyev N, Tusun E, et al. 2014. A rare cause of congestive heart failure after seven years of open heart surgery: Organized intrapericardial hematoma. Anadolu Kardiyol Derg. 14(2):205-8.
Author Disclosure & Copyright Transfer Agreement
In order to publish the original work of another person(s), The Heart Surgery Forum® must receive an acknowledgment of the Author Agreement and Copyright Transfer Statement transferring to Forum Multimedia Publishing, L.L.C., a subsidiary of Carden Jennings Publishing Co., Ltd. the exclusive rights to print and distribute the author(s) work in all media forms. Failure to check Copyright Transfer agreement box below will delay publication of the manuscript.
A current form follows:
The author(s) hereby transfer(s), assign(s), or otherwise convey(s) all copyright ownership of the manuscript submitted to Forum Multimedia Publishing, LLC (Publisher). The copyright transfer covers the exclusive rights to reproduce and distribute the article and the material contained therein throughout the world in all languages and in all media of expression now known or later developed, including but not limited to reprints, photographic reproduction, microfilm, electronic data processing (including programming, storage, and transmission to other electronic data record(s), or any other reproductions of similar nature), and translations.
However, Publisher grants back to the author(s) the following:
- The right to make and distribute copies of all or part of this work for use of the author(s) in teaching;
- The right to use, after publication in The Heart Surgery Forum, all or part of the material from this work in a book by the author(s), or in a collection of work by the author(s);
- The royalty-free right to make copies of this work for internal distribution within the institution/company that employs the author(s) subject to the provisions below for a work-made-for-hire;
- The right to use figures and tables from this work, and up to 250 words of text, for any purpose;
- The right to make oral presentations of material from this work.
Publisher reserves the right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. To republish, such third parties must obtain written permission from the Publisher. (This is in accordance with the Copyright Statute, United States Code, Title 17. Exception: If all authors were bona fide officers or employees of the U.S. Government at the time the paper was prepared, the work is a “work of the US Government” (prepared by an officer or employee of the US Government as part of official duties), and therefore is not subject to US copyright; such exception should be indicated on signature lines. If this work was prepared under US Government contract or grant, the US Government may reproduce, royalty-free, all or portions of this work and may authorize others to do so, for official US Government purposes only, if the US Government contract or grant so requires.
I have participated in the conception and design of this work and in the writing of the manuscript and take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published, has been submitted for publication elsewhere, or will be submitted for publication elsewhere while under consideration by The Heart Surgery Forum, except as described in an attachment. I have reviewed this manuscript (original version) and approve its submission. If I am listed above as corresponding author, I will provide all authors with information regarding this manuscript and will obtain their approval before submitting any revision. I attest to the validity, accuracy, and legitimacy of the content of the manuscript and understand that Publisher assumes no responsibility for the validity, accuracy, and legitimacy of its content. I warrant that this manuscript is original with me and that I have full power to make this Agreement. I warrant that it contains no matter that is libelous or otherwise unlawful or that invades individual privacy or infringes any copyright or other proprietary right. I agree to indemnify and hold Publisher harmless of and from any claim made against Publisher that relates to or arises out of the publication of the manuscript and agree that this indemnification shall include payment of all costs and expenses relating to the defense of any such claim, including all reasonable attorney’s fees.
I warrant that I have no financial interest in the drugs, devices, or procedures described in the manuscript (except as disclosed in the attached statement).
I state that the institutional Human Subjects Committee and/or the Ethics Committee approved the clinical protocol reported in this manuscript for the use of experimental techniques, drugs, or devices in human subjects and appropriate informed consent documents were utilized.
Furthermore, I state that any and all animals used for experimental purposes received humane care in USDA registered facilities in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (NIH Publication No. 85-23, revised 1985).