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A case of mesothelial/monocytic cardiac excrescence causing severe acute cardiopulmonary failure

Truc Thanh Pham1, Kenneth Antons, Ralph Shishido

  • 1Department of Pathology, University of California, San Diego, CA 92103-8720, USA. trucpham@ucsd.edu

The American Journal of Surgical Pathology
|March 16, 2005
PubMed

Insights

Mesothelial/monocytic incidental cardiac excrescence (MICE) can mimic serious conditions. This report details a rare MICE case causing acute heart failure, emphasizing diagnostic challenges.

Area of Science:

  • Cardiovascular Pathology
  • Surgical Pathology

Background:

  • Mesothelial/monocytic incidental cardiac excrescence (MICE) is a benign cardiac lesion.
  • Its etiology remains debated, with theories including artifact versus reactive process.
  • MICE can be mistaken for malignant tumors, posing diagnostic challenges.

Observation:

  • A 65-year-old male presented with severe acute aortic regurgitation.
  • Transesophageal echocardiography revealed a 2.0-cm mobile aortic valve vegetation.
  • Surgical visualization confirmed the vegetation and additional free-floating masses.

Findings:

  • Histopathological examination identified a nodule rich in histiocytes and mesothelial cells, with fibrin and neutrophils.
  • Immunohistochemistry confirmed the cellular composition of the lesion.
  • This represents the first documented instance of MICE precipitating acute cardiopulmonary failure.

Implications:

  • Accurate diagnosis of MICE is crucial to avoid misclassification as malignancy.
  • This case highlights MICE as a potential cause of acute cardiac decompensation.
  • Further research into MICE pathogenesis and clinical significance is warranted.

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