Intracardiac mass as initial cardiac manifestation of Behçet's disease: think before you cut

Area of Science:

• Cardiology
• Rheumatology
• Pathology

Background:

• Behçet's disease (BD) is a chronic inflammatory disorder affecting multiple systems.
• Cardiac involvement, including intracardiac thrombi, occurs in up to 16% of BD cases.
• Cardiac manifestations can present with diverse symptoms like fever, dyspnea, and chest pain.

Observation:

• Two cases of intracardiac masses initially suspected as malignancies were reported.
• Post-surgical pathological evaluation revealed inflammatory masses due to Behçet's disease.
• Intracardiac masses can be the initial presentation of undiagnosed BD.

Findings:

• Unexplained intracardiac masses necessitate considering BD in the differential diagnosis.
• Thorough patient history and physical examination for BD symptoms are crucial prior to surgical intervention.
• Diagnosis of cardiac BD requires a multidisciplinary approach integrating clinical, imaging, and pathological findings.

Implications:

• Echocardiographers should include BD in the differential diagnosis for intracardiac masses.
• Prompt recognition and diagnosis of cardiac BD can prevent unnecessary surgeries.
• Anti-inflammatory therapy is the cornerstone of treatment for cardiac manifestations of Behçet's disease.