A Rare Case of Cavernous Hemangioma of the Mitral Valve Presenting As Multifocal Embolic Brain Infarcts

Abstract

Primary cardiac tumors (PCTs) are rare and represent a heterogeneous group of tumors, potentially arising from various parts of the heart. The majority of these tumors are benign (90%), with myxoma being the most common subtype. Cardiac hemangiomas are rare vascular tumors that constitute 1-2% of all benign heart neoplasms. We present a rare case of a 79-year-old woman presented with multifocal embolic brain infarcts secondary to cavernous hemangioma of the mitral valve (MV). Cavernous hemangioma was successfully resected with follow-up imaging at six months, demonstrating no regrowth. There are no pathognomonic signs or findings to suggest cavernous hemangioma of the MV on clinical examination or imaging studies. Surgical resection and histopathologic analysis remain the gold standard for diagnosis and treatment, respectively. Following complete resection, the prognosis is generally favorable with a low recurrence rate, but periodic echocardiography is recommended to detect any potential recurrence.

Keywords: cavernous hemangioma; fibroelastoma; infarcts; mitral valve; myxoma.

Figure 1. TEE demonstrating a pedunculated 1.0 × 0.7 cm mass on the annulus of the anterior leaflet of the MV, which appears to be connected by a stalk.

MV: Mitral valve; TEE: Transesophageal echocardiogram.

Figure 2. MRI brain demonstrating several punctate acute microinfarcts within the left frontal lobe and the bilateral occipital lobes.

Figure 3. H&E stain showing thin-walled vascular spaces with dystrophic calcifications in adjacent connective tissue space.