2025/08/09 by Ping Tian, Jianmin Zheng, Jingji Xu +1 · 1 voice
Medicine · #Histiocytic Disorders and Treatments #Tumors and Oncological Cases
paper · doi:10.1093/ehjci/jeaf235
openalex publication_date 2025/08/09 · openalex created_date 2025/08/14 · openalex updated_date 2026/07/29
A 42-year-old woman suffered from intermittent dizziness for more than 3 months, and physical examination revealed a heart mass. The positron emission tomography/computed tomography (CT) scan revealed a soft tissue mass of 3.2 × 4.9 cm in the ventricular septal area at the apex of the heart with abnormally elevated glucose metabolism (Panel A). CT coronary angiography revealed a well-defined mass that surrounded the left anterior descending artery, with heterogeneous density and mild enhancement (Panels B and C). CT 3D image segmentation (Panel D; Supplementary data online, Movie S1) clearly displayed the relationship between the tumour (marked by yellow) and the anterior descending branch (marked by purple). The tumour presented significantly non-homogeneous enhancement on late gadolinium enhancement (LGE) imaging (Panel E). The women treated with echocardiography-guided transapical radiofrequency ablation for cardiac tumours (TARFACT), which offered a less invasive palliative therapy option. Histopathology confirmed the cytological diagnosis of granular cell tumour (GCT) (Panel F). The LGE imaging (Panels G and H) revealed that the tumour size was significantly decreased during follow-up period (2-month, 6-month), and coagulative necrosis in the central part and reactive myocardial fibrosis at the margin (red arrow), and the high signal area at the apex of the left ventricle might be the residual part of the tumour (yellow triangle). The extracellular volume fraction mapping visually displayed the residual tumour component at the 2-month follow-up (Panel I, white arrow). Here, an extremely rare primary GCT was first reported and treated with TARFACT. Additionally, we found multimodal imaging played an essential role in pre-operative diagnosis and post-operative follow-up.