https://doi.org/10.4081/monaldi.2025.3221
An unexpected and tumultuous diagnosis of a left atrial mass
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Published: 21 January 2025
This case presents a curious diagnosis in a young male presenting with chest pain. The first imaging tests suggested the presence of a hypovascular left atrial tumor. After cardiac magnetic resonance and the exclusion of extra-cardiac lesions, sarcoma emerged as the main diagnostic hypothesis. Unexpectedly, the histopathological study revealed the absence of malignancy, identifiable inflammatory and cardiac muscle tissue, and fibrosis. This pattern was compatible with inflammatory myofibroblastic tumor diagnosis, a rare entity with uncertain behavior but a known risk of recurrence and/or potentially fatal complications. This is a unique case of an unexpected finding at presentation, as well as a complex diagnostic work-up and a surprisingly unusual final diagnosis. It also highlights the increasing importance of the multimodality imaging approach, as well as the critical role of multidisciplinary discussion in optimizing patient management in such complex cases.
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D'Angelo T, Mazziotti S, Inserra MC, et al. Cardiac inflammatory myofibroblastic tumor. Circ Cardiovasc Imaging 2019;12:e009443 DOI: https://doi.org/10.1161/CIRCIMAGING.119.009443
Suzuki S, Ohtani M, Matsuo Y, et al. A forensic autopsy case: sudden unexpected death due to cardiac inflammatory myofibroblastic tumor. Leg Med 2021;53:101931. DOI: https://doi.org/10.1016/j.legalmed.2021.101931
Pino PG, Moreo A, Lestuzzi C. Differential diagnosis of cardiac tumors: general consideration and echocardiographic approach. J Clin Ultrasound 2022;50:1177-93. DOI: https://doi.org/10.1002/jcu.23309
Henriques de Gouveia R. Inflammatory myofibroblastic tumor of the heart: a brief overview. Rev Port Cardiol 2023;42:171-2. DOI: https://doi.org/10.1016/j.repc.2022.12.010
Domínguez-Massa C, Doñate-Bertolín L, Blanco-Herrera ÓR, et al. Inflammatory myofibroblastic tumor: a rare entity with a complex diagnosis. Rev Port Cardiol 2023;42:169.e1-e4. DOI: https://doi.org/10.1016/j.repc.2022.12.007
Yang X, Xiao C, Liu M, Wang Y. Cardiac inflammatory myofibroblastic tumor: does it recur after complete surgical resection in an adult? J Cardiothorac Surg 2012;7:44. DOI: https://doi.org/10.1186/1749-8090-7-44
Dehner C, Dehner L. Inflammatory myofibroblastic tumor. Available from: https://www.pathologyoutlines.com/topic/softtissueinflammyofibro.html.
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