Cardiac tumors - benign

Topic Completed: 1 November 2013

Revised: 26 September 2019

Copyright: 2007-2019, PathologyOutlines.com, Inc.

PubMed Search: Hemangioma [title] heart review[ptyp]

Nat Pernick, M.D.
Page views in 2018: 453
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Cite this page: Pernick N. Hemangioma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/hearttumorhemangioma.html. Accessed October 16th, 2019.
Definition / general
  • Rare; < 5% of benign cardiac tumors
  • All ages
  • 30% are multiple
  • Usually asymptomatic but may cause sudden death or significant cardiac dysfunction by displacing large portions of atria and ventricles
Case reports
  • 57 year old man with necrotic cardiac haemangioma masquerading as sepsis with disseminated intravascular coagulation (Hong Kong Med J 2005;11:308)
  • 65 year old man with papillary endothelial hyperplasia and liver involvement (Heart 2004;90:e49)
  • Complete excision if possible
Gross images
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Right atrial tumor shows hemorrhage and dilated vessels

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Left ventricular tumor

Microscopic (histologic) description
  • Types are capillary (small vessels) or cavernous (multiple dilated thin walled vessels) or arteriovenous (thick walled, dysplastic malformed arteries and veins)
  • No necrosis, no mitotic figures, no atypia
  • Intramural tumors may contain adipose or fibrous tissue
Microscopic (histologic) images

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Small vascular channels

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Mixed capillary - cavernous

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Muscle specific actin outlines vascular channels

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Focus of papillary endothelial hyperplasia

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Mixed capillary - cavernous

Differential diagnosis
  • Angiomatosis: vessels of various sizes with variable wall thickness, adipose tissue and skeletal muscle (Int Heart J 2006;47:469)
  • Angiosarcoma: atypia present
  • Myxoma: hemangiomas may have myxoid background but lack myxoma cells or ring structures
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