Rare Presentation of a Primary Cardiac Mass: Insights Into Multimodal Imaging, Histopathology, and Surgical Management

Primary cardiac tumors are exceedingly rare, with cardiac hemangiomas constituting 1% to 3% of benign cardiac tumors, making diagnosis and management challenging. A 49-year-old female presented with progressive chest tightness over several years. Multimodal imaging revealed a large cardiac mass within the pericardial space, encasing the left anterior descending artery. Following an inconclusive tissue sampling attempt, surgical resection was performed to guide therapy. Histopathology confirmed cardiac cavernous hemangioma. Multimodal imaging is crucial for characterizing cardiac masses and guiding biopsy and treatment strategies (eg, surgical for sarcoma if feasible versus nonsurgical for lymphoma). Cardiac hemangiomas often present with nonspecific symptoms. Surgical resection remains the definitive treatment, providing symptom relief and histopathologic confirmation.