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Abstract
Cardiac masses are rare, the differential diagnosis includes infections with vegetations or abscesses, neoplasms, thrombi, and structural abnormalities. A pathology specimen is essential in therapeutic strategy planning for a cardiac mass, also if the primary imaging findings look dramatic at the start. Even in an inoperable setting, a life-saving therapy might be available. We report a case of a 49-year-old man, known with HIV-1, who was several times admitted with pericarditis. Now he was hospitalized with progressive lower limb edema, atrial fibrillation and detection of a giant cardiac mass in left and right atrium with infiltration of surrounding tissues. Given the extent and invasiveness of the mass, he was inoperable. Biopsy specimen was obtained and staging was performed by PET-CT scan. The diagnosis of stage IV Burkitt lymphoma with predominant extranodal cardiac involvement was withheld wherefore promptly aggressive therapy was started according to the GMALL B-NHL86 protocol. The therapy was downgraded to R-CHOP due to tolerance problems. He achieved a complete remission and during follow-up no relapse was detected.
Acknowledgments
Delphine MTF Vervloet: research, follow-up patient as trainee, writing. Michel DE Pauw: attending physician for cardiological work out, treatment and follow-up, revising text critically. Laurent Demulier: responsible for echocardiographic follow-up and admitted images, revising text critically. Jan Vercammen: attending physician as primary cardiologist, revising text critically. Wim Terryn: attending physician as HIV specialist, revising text critically. Eva Steel: attending physician as hematologist, co-writer, revising text critically. Linos Vandekerckhove: attending physician as HIV specialist, follow-up patient, co-writer, revising text critically.