Visceral pericardial hemangioma: Unusual location for a rare cardiac tumor

A 41-year-old man presented with chest pain and a positive electrocardiographic stress treadmill test. Coronary angiography revealed no significant coronary disease, but suggested a mass posterior to the heart. Transthoracic and transesophageal echocardiography revealed a smooth-surfaced mass in the inferoposterior atrioventricular groove, with color Doppler evidence of vascular formation within the mass. Magnetic resonance imaging confirmed the presence of the tumor, without extension into adjacent cardiac chambers or pericardial effusion. At operation, a 4.6- × 3.0-cm tumor attached to the visceral pericardium was excised. Pathologic section resulted in a diagnosis of hemangioma. Hemangiomas account for 2% to 5% of benign cardiac tumors, arising from the cardiac ventricles, atria, valves, and, rarely, the epicardium/pericardium. This case illustrates a very rare location for an unusual benign cardiac tumor. The patient recovered after operation without complication.