A young boy from Sassuolo (MO) with a passion for football, during his annual check-up for sports fitness, is found to have an anomaly in his heart. This is the beginning of the story of Giovanni, a 16-year-old who saw his life overwhelmed by an unexpected event: the diagnosis of a heart tumor and a delicate, highly complex operation performed at Salus Hospital of Reggio Emiliawho managed to give him back all the possibilities that life can offer him.
The sporting preparation before the start of the championship is about to start again and Giovanni, as usual, undergoes a sports medical examination: the result of the echocardiogram requires further investigation.
“I thought it was a normal check – comments Giovanni –, I was really disappointed when I discovered there was more.”
Cardiac imaging tests are performed routinely and with a certain expertise at Salus Hospital and these tests in fact confirm the presence of a 1.4 cm cardiac tumor, a “little ball” located in the heart, in the cavity of the left ventricle.
The diagnostic process was possible thanks to the synergistic work of the doctors: Dr. Luca Piccininisports doctor, Dr Evelina Faragassocardiologist and head of advanced cardiac imaging, coronary CT and Cardio MRI, at Salus Hospital, and Dr. Andrea Barbierihead of the ultrasound laboratory of the University Polyclinic of Modena.
“The position of the mass, in correspondence with the cardiac apex originating from a false tendon cord, and its considerable size, made it necessary to intervene in the short term – says Dr. Vinicio Fiorani, head of the Cardiac Surgery Unit at Salus Hospital –-. This type of tumor is very rare and has a tendency to grow, with the risk of obstructing blood flow or detaching and embolizing damaging other organs (such as the brain with the serious consequence of a stroke). It must therefore be removed. We decided to intervene in a minimally invasive way, in a mini-thoracotomy, safeguarding very important structures in the heart. In the literature there is only one case of a hemangioma removed minimally invasively, we can therefore claim to be the first to remove a capillary type hemangioma in a minimally invasive manner. All this confirms Salus Hospital as a point of reference for highly complex heart operations and with microinvasive and minimally invasive methods that allow us to reduce trauma to the patient both during the operation and in post-operative recovery”.
After a short period in intensive care, coordinated by Dr. Antonello RagoGiovanni finished his stay in the ward with 15 days of cardiorespiratory rehabilitation.
A cancer diagnosis is always a hard blow for an adult, even more significant when it concerns a teenager, with emotional repercussions not only on the young person but on the entire family.
“It was a bolt from the blue – recalls the boy’s mother -. All the doctors, nurses and service workers were very kind, they welcomed us with open arms and made us feel understood. The Dr. Fiorani, a very positive person, was able to reassure us about the operation and this allowed us to return home peacefully.”
Today there are in fact diagnostic tests, such as cardiac magnetic resonance imaging and cardiac CT, which, thanks to their non-invasiveness and high resolution of the images produced, allow the identification of small anomalies and in difficult positions, in the initial stages of the pathology, sometimes not always well visible with a simple echocardiogram, as in this case. These tests become fundamental as a support for a reference Cardiac Surgery such as that of Salus Hospital.
Giovanni will have to be patient but with time he will be able to return to leading a normal life and playing football.
“After the operation I spent some time at home and on Monday 15 April, less than a month after the operation, I returned to school. It was a bit like starting over after the summer holidays. I am happy to resume many aspects of normal life and I was really happy to find all the support from my classmates and teachers, which was never lacking during the days when I had to stay at home. Now the goal is to return stronger than before on the football pitches too,” says Giovanni.
Subject to obtaining sporting eligibility, Giovanni will be able to return to playing football from September.
The histological examination, carried out following the surgery to remove the mass, confirmed the benign and rare nature of Giovanni’s tumor: it is a capillary hemangioma and, given both the type and location, constitutes an extremely rare case world.
Capillary hemangiomas represent 2.8-5% of benign heart tumors which in turn account for 75% of all cardiac tumors. Heart tumors have an autopsy prevalence of 0.002-0.3%, which gives an idea of the rarity of cardiac capillary hemangioma.
Hemangiomas can arise at any age, both asymptomatic and presenting a wide range of symptoms depending on their location and size. Although benign, they can cause obstruction to blood outflow or embolize. The diagnostic gold standard is primarily the transthoracic and transesophageal echocardiogram, cardiac Magnetic Resonance Imaging can be very useful in the differential diagnosis. The treatment of choice is surgical excision of the tumor. Follow-up can be performed with transthoracic echocardiography to exclude recurrence.
