A Case report of the largest Right Ventricular Hémangioma

February 3, 2019



Primary cardiac tumors are rare and often asymptomatic or present with unspecific symptoms.

Benign cardiac tumors of vascular origin are especially rare, with only few existing data in the literature. 

Case presentation:

 A 26-year-old woman presented cardiac symptoms like palpitations four month earlier; he started complaining of fatigue and mild exercise dyspnea. His cardiologist discovered a systolic murmur. Echocardiography showed a large right ventricular mass, which engaged in the tricuspid valve in hoes generating a transtricuspidien gradient of 15 mmHg,

 Our patient then underwent cardiovascular magnetic resonance (CMR) imaging and a thoracoabdominopelvic CT scan the day after admission, which revealed that there isn’t enormous than this mass

The surgeons were preparing to operate the patient but the patient's biological assessment was disrupted, and

2 days later a cardiogenic shock state requiring administration of dobutamine without improvement.

The evolution was marked by the installation of a severe bradycardia with impaired consciousness with a GCS 3 having motivated the family to take agonizing to his parental home, the patient unfortunately died on his arrival home.


We conclude that MRI is advantageous over a combination of TTE and TEE for the detection and complete morphological and functional evaluation (hemodynamic effects) of cardiac masses.



CMR, Cardiac Tumor, Echocardiography, Intracardiac angioma


Reynen K. Frequency of primary tumors of the heart. Am J Cardiol. 1996;77:107.

Shapiro LM. Cardiac tumors: diagnosis and management. Heart. 2001;85:218

Yan XG, Jia B, Zhu BX, Hu XH. Successful resection of a primary cardiac fibroma in a neonate: report of a case. Surg Today. 2014 Sep;44(9):1768-70.

Gopal AS, Stathopoulos JA, Arora N, Banerjee S, Messineo F. Differential diagnosis of intracavitary tumors obstructing the right ventricular outflow tract. J Am Soc Echocardiogr. 2001 Sep;14(9):937-40.

Reiss N, Theissen P, Feaux de Lacroix W. Right-ventricular hemangioma causing serious outflow-tract obstruction. Thorac Cardiovasc Surg. 1991 Aug;39(4):234-6.

Iba Y, Watanabe S, Akimoto T, Abe K, Koyanagi H. Pedicled cardiac hemangioma with right ventricular outflow tract obstruction. Jpn J Thorac Cardiovasc Surg. 2005 May;53(5):269-71.

Ainsworth CD, Salehian O, Nair V, Whitlock RP. A bloody mass: rare cardiac tumor as a cause of symptomatic ventricular arrhythmias. Circulation. 2012 Oct 9;126(15):1923-31.

El Fawal S, El Metwally EA. Report of a right ventricular outflow tract myxoma in a young adult. J Cardiovasc Magn Reson. 2015; 17(Suppl 1): P374.

Gribaa R, Slim M, Kortas C, Kacem S, Ben Salem H, Ouali S, Neffati E, Remadi F, Boughzela E. Right ventricular myxoma obstructing the right ventricular outflow tract: a case report. J Med Case Rep. 2014 Dec 17;8:435.

McAllister H. Tumors of the heart and pericardium. In: Silver MD, editor. Cardiovascular pathology. New York: Churchill Livingstone; 1983. p. 909e43.

Sharma J, Hsu D, Weinstein S. Obstructive right ventricular outflow tract hemangioma in an adolescent. Congenit Heart Dis. 2011 Nov-Dec;6(6):657-60.

Botha J, Ihlberg L, Elhenawy A, Abbott M, Butany J, Paul N, Brister SJ. A giant cavernous hemangioma of the heart. Ann Thorac Surg. 2010 Jul; 90(1):293-5.

Moreira D, Rodrigues B, Delgado A, Nascimento C, Nunes L, Nobre A, Cravino J, Santos O. Hemangioma of the right ventricular outflow tract, clinical report. Rev Port Cir Cardiotorac Vasc. 2012 Apr-Jun;19(2):79-81.

Soberman MS, Plauth WH. Hemangioma of the right ventricle causing outflow tract obstruction. J Thorac Cardiovasc Surg 1988.

Author Details

Y. Kettani

O. Louizi

S. Hallab

N. Doghmi

M. Cherti

A. Saoud

A. Bakkari

Y. Elfakir