Keywords:
Cardiac, Oncology, MR, Echocardiography, CT, Surgery, Imaging sequences, eLearning, Neoplasia, Tissue characterisation
Authors:
C. Saborido Avila, M. Rodríguez Álvarez, E. Paredes Galan, B. Nieto Baltar, R. Cascais Pampin, M. B. Iglesias Rodriguez; Vigo/ES
Methods and Materials
We present a 28-year-old female from an endemic Chagas disease country,
without cardiovascular risk factors,
toxic habits or relevant pathologic background of infectious disease.
The patient suffered an episode of acute chest pain three years ago without medical reporting. Now she presents a new chest pain not related to exercise,
with normal laboratory test and left bundle branch block in this moment.
There isn´t signs of acute coronary syndrome.
Echocardiography shows an anomalous left ventricle apex with small aneurisms.
The MRI shows multiple lipomasFig. 2 .
Fig. 2: The MRI shows multiple lipomas. A giant subepicardial with myocardial in the LV and small subendocardial rights lipomas. There are small fatty implants in the ventricles.
A giant subepicardial tumor isointense to the fat in all secuencesFig. 3 parcially encapsuled with myocardial extension encasing the whole heart and infiltrating the left ventricular free wall,
the septum and papillary muscle withFig. 5 focal disruption of myocardial wall and subsequent aneurysm formationFig. 6.
Small subendocardial rights lipomas and scattered fat in right and left ventricular wall coexistFig. 5 .
Fig. 3: The tumor is isointense to fat in all secuences.
Fig. 4: MRI showed a capsule that was not found in the surgery.
Fig. 6: MRI shows two defects in the base of the tumor than comunicate with the LV cavity. In ventriculography and in the MRI secuence of viability the contrast acumulate into these two little bags.
References: Galaria. CHUVI. Vigo/Espaa 2012
The function of both ventricles was normalFig. 7 .
Fig. 7: Preoperative cine-MRI 4 chambers view.
We review the bibliography,
the imaging and the surgical piece.