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Inoperable plasma cell granuloma of the heart: spontaneous decrease in size during an 11-month period
P J Pearson1, W A Smithson, D J Driscoll
1Department of Physiology and Biophysics, Mayo Clinic, Rochester, MN 55905.
Insights
Plasma cell granuloma, a rare condition, can present as a cardiac mass in children. This atypical case showed spontaneous regression, suggesting observation as a viable treatment option.
Area of Science:
- Pediatric Pathology
- Cardiovascular Surgery
- Oncology
Background:
- Plasma cell granuloma (PCG) typically presents as an intrapulmonary mass in children.
- Surgical excision is the standard curative treatment for PCG.
- Atypical presentations of PCG require consideration in differential diagnoses.
Observation:
- An asymptomatic, unresectable cardiac mass was identified in a child.
- The cardiac mass was diagnosed as a plasma cell granuloma.
- The mass demonstrated significant spontaneous size reduction over 11 months.
Findings:
- This case represents an atypical, unresectable cardiac plasma cell granuloma in a pediatric patient.
- The cardiac mass showed a 40% spontaneous decrease in size over an 11-month observation period.
- Complete resolution was not achieved, but significant regression occurred without intervention.
Implications:
- Plasma cell granuloma should be included in the differential diagnosis for pediatric cardiac masses.
- Observation may be a suitable management strategy for unresectable cardiac plasma cell granulomas.
- This case highlights the potential for spontaneous regression of cardiac plasma cell granulomas, challenging traditional treatment paradigms.
Abstract:
Plasma cell granuloma occurs in children, typically as an intrapulmonary mass. Surgical excision is the treatment of choice and is usually curative. We report an atypical and unresectable plasma cell granuloma that occurred asymptomatically in the heart of a child and spontaneously decreased in size by 40% during an 11-month period. Thus, plasma cell granuloma should be considered in the differential diagnosis of any child who has a cardiac mass. Observation should be considered a treatment option because this case demonstrated that the cardiac mass can spontaneously recede without therapy.