Resection of a right atrial epithelioid hemangioendothelioma

A right atrial mass excised from the heart of a 53-year-old man was incidentally found to be an epithelioid hemangioendothelioma (EHE). EHE is a rare malignant tumor with marked variability in clinical outcomes. Cardiac involvement is unusual but does occur [Bisesi MA, Broderick LS, Smith JA. MR demonstration of right atrial involvement in multifocal epithelioid hemangioendothelioma. AJR Am J Roentgenol 1996;167(4):953-4; Di Biasi P, Scrofani R, Santoli C. Cardiac hemangioendothelioma. Ann Thorac Surg 1995;59(3):792-3], and the prognostic is usually considered relatively good after resection. However, the tumor in this case shows atypical features, which raises concerns. In addition to complete en bloc resection, a close follow-up is considered mandatory.