Hamartoma of mature cardiomyocytes in right atrium: A case report and literature review

Our plain-English summary of Hamartoma of mature cardiomyocytes in right atrium: A case report and literature review, by X. Zhou, Y. Zhou, Y. Zhaoshun, et al (Medicine, 2019).

The study

• Authors: X. Zhou, Y. Zhou, Y. Zhaoshun, M. Zeng, X. Zhou, X. Liao, Z. Zhang
• Journal: Medicine
• Published: 2019;98(31):e16640
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Rationale: Tumors in the heart are rare. Myxomas, rhabdomyomas, and fibromas are the most common benign cardiac tumors. Hamartoma of mature cardiomyocytes (HMCM) is another benign cardiac tumor, are very rare and have only been reported in a few literatures.

Patient Concerns: We report a case of 41-year-old male who suffered short of breath for 3 years, and lower limbs edema for 2 years.

Diagnoses: Transthoracic echocardiogram (TTE) and cardiac magnetic resonance (CMR) showed a large amount of pericardial effusion and confirmed a mass of 18 × 14 mm on the superior vena cava near the outer edge of right atrium. The patient was first diagnosed as pleural mesothelioma. Surgery was performed to relieve the symptoms and confirm diagnoses. However, during surgery, we found the right atrium is apparently thicken with rough and uneven surface. Histology of right atrium mass indicated it as hamartoma of mature cardiomyocytes.

Intervention: We resected the thicken atrial wall completely, reconstructed right atrium with bovine pericardial patch, and resected the pericardium.

Outcomes: Patient was discharged 9 days after surgery, and remained asymptomatic during 9 months follow up.

Lessons: Hamartoma of mature cardomyocytes is a rare benign cardiac tumor. There were 26 cases reported until now. The conclusive diagnosis depends on pathological sections. For patients with symptoms, surgery is an effective treatment for HMCM.

In plain English

This case report with a literature review concerns hamartoma of mature cardiomyocytes (HMCM), a rare benign heart tumor. It does not study asbestos. The patient, a 41-year-old man in Changsha, China, had been short of breath for 3 years and had leg swelling for 2. A local hospital diagnosed tuberculous pericarditis, though his TB-Spot test was negative. When symptoms returned, imaging at the authors' hospital showed a large pericardial effusion and a mass near the right atrium, and his diagnosis before surgery was pleural mesothelioma. At surgery the right atrial wall was thickened; tissue examination identified HMCM instead. Surgeons removed the thickened wall, rebuilt the atrium with a bovine pericardial patch and removed the pericardium. He had no symptoms or effusion during 9 months of follow-up. Reviewing 25 earlier published patients plus this one, the authors reported that 16 of 26 were male, 12 had no symptoms, and all surgical patients were alive without recurrence during follow-up of 2 months to 14 years. They concluded that diagnosis depends on pathology and surgery is effective for patients with symptoms.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of one patient with a review of previously published cases
• Who was studied: One 41-year-old man admitted on April 16, 2018 to the Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China. The literature review covered 25 previously published patients plus this case (26 in total), found in PubMed and MEDLINE from March 1947 to Oct 2018.
• Exposure: No asbestos or other environmental or occupational exposure is studied or reported. The article concerns a benign heart tumor (HMCM).
• Main results:
  • Before referral, a local hospital found a large pericardial effusion and diagnosed tuberculous pericarditis, although the TB-Spot test was negative.
  • After imaging at the authors' hospital showed a mass on the superior vena cava near the outer edge of the right atrium, the patient's diagnosis before surgery was pleural mesothelioma.
  • Tissue taken during surgery was identified as hamartoma of mature cardiac myocytes (HMCM).
  • The patient was discharged 10 days after surgery (according to the case report section) and had no symptoms or pericardial effusion during 9 months of follow-up.
  • The literature review identified 25 previously reported patients with HMCM, and the authors analyzed these together with this case.
  • Among the 26 reviewed patients, 62% (16 of 26) were male.
  • Among the 26 reviewed patients, 46% (12 of 26) had no symptoms. The most common symptom was chest pain or chest tightness (35%, 9 of 26).
  • Pericardial effusion was found in 4 of the 26 reviewed patients (15%), and in all 4 the tumor was on the right side of the heart.
  • Among reviewed patients who had surgery, all were alive and no recurrence was found during follow-up ranging from 2 months to 14 years.
• The authors' conclusion: The authors concluded that HMCM is a rare benign cardiac tumor, that a conclusive diagnosis depends on pathological sections, and that surgery is an effective treatment for patients with symptoms.

Topics

Medical terms in this study, explained in our Lexicon: Echocardiogram, Pericardial Effusion, Pleural Mesothelioma, Histology, Pericardial, Pericardium.

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