Rare Case of Hamartoma Mimicking Fibroma and Correlations with Literature

Abstract

Background: The incidence of primary cardiac tumors ranges from 0.02 to 0.05% in autopsy studies. Hamartomas from mature cardiac myocytes do not present a predilection for age at detection and present a higher prevalence in the left ventricle with the advent of extracorporeal circulation and the advancement of image diagnostic medicine such as echocardiography, computed tomography and magnetic resonance imaging, diagnosis and surgical treatment became more feasible. Objective: To present the case report of a very rare HA with diagnosis by clinical correlation, imaging equipment and microscopy, in order to differentiate it from fibroma. Case: A 63-year-old female patient with a history of chest pain and dyspnea on exertion with progressive worsening six months ago. The echocardiogram presented apical akinesia with an intramyocardial fibro-calcified mass, presenting an intense local coronary vascularization, with a dilated epicardial coronary artery at the tip with 5.0 mm, where the intramyocardial vessels that irrigate the tumor of the apical region originate. A superficial myocardial bridge was visualized by MRI in the middle segment of aDA. The patient underwent endomyocardial biopsy with a suggestive result of Hamartoma of mature cardiac myocytes. Conclusion: Despite the diverse range of cardiac neoplasms, heart tumors are very rare, even more so as the apical Hamartoma and confused with fibroma presented in the present work.