Solitary cardiac cysticercosis

Abstract

Cardiac cysticercosis is rare in clinical practice and is usually accidentally identified during cardiac surgery or autopsies. Although mostly asymptomatic, cardiac cysticercosis could present with severe clinical conditions such as myocarditis, acute myocardial infarction, and arrhythmia. We present a 51-year-old female patient who accidentally discovered a solitary mass in the myocardium. The cardiac magnetic resonance imaging revealed a nonenhanced cyst in the interventricular septum protruding into the right ventricular chamber. Because of cardiac tamponade presenting during a right ventricular endomyocardial biopsy, an emergency open-heart surgery was performed to suture the ventricular wall perforation and remove the tumor. The histopathologic report demonstrated typical cysticercosis. Cardiac cysticercosis is an uncommon lesion and may present with atypical clinical and laboratory features. Therefore, this diagnosis should be considered single or multiple cardiac cystic lesions.

Keywords: Cardiac MRI; Cardiac cysticercosis; Myocardial biopsy.

Fig. 1

(A) Echocardiogram showing a heterogeneous hyperechoic mass in the interventricular septum (white arrow). Cardiac magnetic resonance imaging showed a mass (white arrows) in the interventricular septum protruding into the right ventricular chamber, clearly visible on short-axis (C) and 4-chamber cine (D) images, hyperintense on STIR (B), hypointense on T1W (E), and no enhancement after gadolinium injection (F).

Fig. 2

(A) Intraoperative lesion image (black arrow). Histopathology of the mass revealed multiple inflammatory infiltrates, mainly eosinophils (B) (HE ×100) and numerous tapeworms (C) (PAS×200).