Unveiling the Unforeseen: Left Ventricular Fibroma Recurrence or Rare Complication? A Multimodality Imaging...

Postoperative intramyocardial abscess may present with echocardiographic features indistinguishable from tumor recurrence. Cardiac magnetic resonance (CMR) with late gadolinium enhancement is critical for accurate differentiation and diagnosis.The surgical technique of using two dissimilar xenopericardial patches can create a potential dead space, serving as a nidus for infection and subsequent abscess formation despite an initially uncomplicated postoperative course.CMR findings of a T2-hyperintense core without early enhancement, surrounded by an enhancing rim, are characteristic of a contained hematoma or abscess. This signature pattern effectively rules out true neoplastic recurrence.

Cardiac fibroma is a sporadic primary cardiac tumor that is more prevalent in children but accounts for approximately 1% of cardiac tumors in the adult population. It is a benign tumor consisting of fibroblasts and connective tissues, typically associated with a favorable prognosis. Nonetheless, large fibromas may have a poorer prognosis due to the increased risk of arrhythmias and sudden cardiac death.In this case report, we describe a 38-year-old woman who experienced chest discomfort and shortness of breath roughly 3 months following the total resection of a left ventricular fibroma. The initial suspicion was the recurrence of fibroma, but upon further investigation, an intriguing scenario unfolded: the formation of a hematoma and abscess at the previous surgical site. Ultimately, the patient underwent redo-cardiac surgery.