A Rock In The Heart: Rare Abnormality
A 40 Year gentleman presented with occasional dull aching left chest pain and minimal shortness of breath on exertion. Chest X Ray done by his General Physician revealed a large white out calcific mass (Appearing like a piece of rock) in the middle zone on the left side. He was then referred to Dr Manish Garg for expert management.
We did a detailed evaluation and investigation. CT Chest revealed a completely homogenous calcific pericardial tumor measuring 10x8x5cm with collapse of the surrounding lung tissue. A whole Body scan did not show similar tumor elsewhere. 2D ECHO was normal and ECG did not have any electrical abnormality.
Patient went under the knife through a left anterior mini thoracotomy and complete excision of this challenging tumor was done successfully. The surgery was done on a beating heart without the use of Heart Lung Machine. The tumor weighed more than 250gms. The post operative course was uneventful and the patient was discharged soon after.
Calcific Fibrous Tumor (CFT) is an extremely rare benign tumor with incidence being less than 1 tumor per year worldwide. Though predominantly reported from GI, Its incidence in the thoracic cavity is less than 10% of all cases. It arising from the pericardium is almost unheard of. It’s very rare for these tumors to be undetected for so long in their natural history. The main cause of symptoms is due to compression of the surrounding structures. Surgical excision is the mainstay of treatment and recurrence is not reported. Complete enucleation of the tumor is possible. The outcomes are very gratifying.