Enlarging left atrial haemangioma in a patient with Cowden syndrome

Area of Science:

• Cardiology
• Oncology
• Pathology

Background:

• Cowden disease is a rare genetic disorder associated with an increased risk of benign and malignant tumors.
• Left atrial masses are uncommon and require thorough investigation for accurate diagnosis and management.

Observation:

• A 53-year-old female with Cowden disease (PTEN mutation positive) was incidentally found to have a left atrial mass during preoperative imaging.
• The mass demonstrated interval growth and led to cardiac tamponade, necessitating urgent surgical intervention.

Findings:

• Diagnostic imaging including CT coronary angiography, MRI, and positron emission tomography characterized the left atrial lesion.
• Histopathological examination confirmed the diagnosis of a cavernous hemangioma, a type of vascular benign tumor.

Implications:

• This case highlights the importance of vigilant surveillance for cardiac masses in patients with Cowden disease.
• Prompt surgical excision can be curative and life-saving in cases of symptomatic cardiac hemangiomas.
• Understanding the diverse manifestations of Cowden disease is crucial for comprehensive patient care.