Giant Right Atrial Cavernous Hemangioma Requiring Extensive Atrial Reconstruction

Cardiac hemangiomas are rare benign tumours that may cause significant haemodynamic compromise when reaching large dimensions. We report a case of a giant right atrial cavernous hemangioma occupying almost the entire atrial cavity and involving multiple adjacent structures. A 55-year-old woman presented with progressive symptoms and was found to have a large right atrial mass on echocardiography and computed tomography. Urgent surgical resection was performed under mild hypothermic cardiopulmonary bypass. The tumour involved the right atrial free wall, interatrial septum, inferior vena cava, coronary sinus, and posterior wall of the left atrium, requiring radical excision and atrial reconstruction using bovine pericardial patches. Tricuspid annuloplasty was performed due to annular dilatation and moderate regurgitation. Postoperative recovery was uneventful, with preserved venous drainage and no new rhythm disturbances. Histopathology confirmed cavernous hemangioma. This case demonstrates that even extremely large benign atrial tumours can be successfully managed with radical resection and tailored reconstruction.