Giant Right Coronary Artery Aneurysm Resembling Cardiac Tumor: A Case Report
DOI:
https://doi.org/10.1532/hsf.2947Keywords:
Coronary artery aneurysm; Heart tumor; EchocardiographyAbstract
Background: Coronary artery aneurysms are not uncommon vascular anomalies, but giant coronary artery aneurysms mimicking cardiac tumors are extremely rare and easily misdiagnosed as tumors. The management and prognosis are not well defined.
Case report: We describe a case of a 50-year-old woman, who had a transthoracic echocardiogram that suggested a cardiac tumor in the right ventricle adjacent to the tricuspid valve and without ventricular wall akinesia. Her medical history was unremarkable, and she had no obvious symptoms. A transesophageal echocardiogram and computed tomography angiogram examination suggested the tumor-like structure was a giant coronary aneurysm, originating from the distal portion of right coronary artery. The patient underwent surgical intervention and recovered uneventfully. Histopathology
of the excised aneurysm showed fibrous tissue hyperplasia with collagenization and calcification in the wall of the artery.
Conclusion: Giant coronary artery aneurysms resembling heart tumors are extremely rare. Differentiating them from cardiac tumors can sometimes be difficult. This rare case emphasizes the importance of combining multiple imaging methods, which helps make accurate diagnosis. For treatment, surgical intervention may be the appropriate therapeutic strategy for the rare lesion.
References
Abou Sherif S, Ozden Tok O, Tas¸köylü Ö, et al. 2017. Coronary artery aneurysms: a review of the epidemiology, pathophysiology, diagnosis, and treatment. Front Cardiovasc Med 4:24.
Ahn CM, Hong BK, Kim JY, et al. 2010. Incidence and natural history of coronary artery aneurysm developing after drug-eluting stent implantation. Am Heart J 160: 987-994.
Ikutomi M, Matsumura T, Iwata H, et al. 2011. Giant tumorous legions surrounding the right coronary artery associated with immunoglobulin-G4-related systemic disease. Cardiology 120: 22-26.
Jha NK, Ouda HZ, Khan JA, Eising GP, Augustin N. 2009. Giant right coronary artery aneurysm--case report and literature review. J Cardiothorac Surg 4:18.
Małgorzata UZ,Robert PB,Maciej K. 2013. Right coronary artery aneurysms in patient with suspicion of heart tumor. Przegl Lek 70(5):356-8.
Ouali S, Kacem S, Ben Fradj F, Gribaa R, Naffeti E, Remedi F, et al. 2011. Takayasu arteritis with coronary aneurysms causing acute myocardial infarction in a young man. Tex Heart Inst J 38: 183-186.
Pahlavan PS, Niroomand F. 2006. Coronary artery aneurysm: a review. Clin Cardiol 29:439-43.
Syed M, Lesch M. 1997. Coronary artery aneurysm: a review. Prog Cardiovasc Dis 40:77–84.
Vivek M, Muhammad AH, Nagesh SA, et al. 2014. Giant coronary aneurysm presenting as a cardiac mass on transthoracic echocardiogram. BMJ Case Rep doi:10.1136/bcr-2013-202536.
Zeb M, McKenzie DB, Scott PA, Talwar S. 2012. Treatment of coronary aneurysms with covered stents: a review with illustrated case. J Invasive Cardiol 24(9):465-9.