A Rare Cardiac Cavernous Hemangioma Treated with Radiotherapy

Abstract

Background: Although cardiac hemangiomas, as rare benign cardiac tumors, have been described in previous case reports, the role of radiation therapy in an unresectable cardiac hemangioma in adult has not been reported. We present a case report of a rare unresectable cardiac cavernous hemangioma treated with radiotherapy. Case Presentation. A 45-year-old female with new onset of coughing and worsening shortness of breath was found to have a biopsy proven cardiac cavernous hemangioma. Surgery was aborted due to excessive bleeding, and she was then treated with radiotherapy. A total dose of 30 Gy in 15 fractions was given using intensity-modulated radiation therapy (IMRT) to the mass with a modified 1 cm margin. Complete clinical symptomatic relief was achieved with reduction of the mass posttreatment. Ten-year follow-up revealed a stable, reduced hemangioma with no recurrence of symptoms.

Conclusions: This is a rare example of cardiac hemangioma that developed in the right ventricle and compressed several major vessels. Radiotherapy may be safely used for treatment of unresectable cardiac hemangioma.

Figure 1

Magnetic resonance imaging at our institution revealed a lesion measuring 8.6 × 13.5 cm.

Figure 2

(a) IMRT radiation treatment plan and dose-volume histogram: clinical target volume (CTV) (red line): 95% of the dose going to 100% of the volume; planning target volume (PTV) (purple line): 95% of the dose going to 95% of the volume; heart (peach-colored line): mean heart dose of 17.2 Gy; lung (blue line): V20 = 5% and V5 = 75%. (b) Dose-volume histogram.

Figure 3

Follow-up magnetic resonance imaging demonstrated decreased size of the lesion posttreatment measuring 3.98 × 10.1 cm.

Figure 4

Follow-up magnetic resonance imaging demonstrated decreased size of the lesion posttreatment measuring 2.96 × 7.17 cm.