Cardiac Hemangioma Producing Pericardial Effusion Detected on Thoracoscopic Pericardial Fenestration

A 76-year-old woman presented with dyspnea. Computed tomography showed massive pericardial effusion, so percutaneous catheter drainage was performed. The usual causes of exudate were ruled out, and no diagnosis was reached. Thoracoscopic pericardial fenestration was performed to obtain a pericardial biopsy specimen and to create a passage allowing longer-term drainage. Observation of the pericardial cavity after the effusion was removed incidentally revealed a tumor measuring 2 cm in diameter located between the left atrial appendage and left pulmonary artery. Surgical resection of the tumor attached to the left atrial appendage was performed. The pathologic diagnosis was hemangioma. (C) 2022 by The Society of Thoracic Surgeons