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Serial imaging revealed a large slowly growing and highly vascularized left ventricular mass, which required surgical resection. Microscopically, the lesion was composed of nodular fibrovascular proliferation with haphazardly embedded muscle bundles and peripheral calcifications. Immunohistochemical studies revealed prominent muscle-specific actin positive and smooth muscle actin positive muscle fiber bundles within a disorganized fibrovascular stroma. This characterization is most consistent with cardiac mesenchymal hamartoma. Relevant differential diagnoses for this lesion include hamartoma of mature cardiac myocytes (HMCMs) and intramuscular hemangioma. The prominent smooth muscle differentiation of muscle bundles was incompatible with defining features of HMCM. Absence of S100-positive nerve and mature adipose cells distinguished this lesion from the recently defined, heterogeneous cardiac mesenchymal hamartoma. Forty-seven cases of cardiac hamartoma reported from 1970 to 2020 were reviewed to provide histopathologic context.<\/jats:p>","DOI":"10.1177\/10668969211002264","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T11:59:46Z","timestamp":1616414386000},"page":"764-769","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Rare Case of Cardiac Mesenchymal Hamartoma and Comprehensive Review of the Literature With Emphasis on Histopathology"],"prefix":"10.1177","volume":"29","author":[{"given":"Soma","family":"Jobbagy","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital, Boston, MA, USA"},{"name":"Soma Jobbagy and Simmi Patel contributed equally to this manuscript."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simmi","family":"Patel","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Medical Center, Pittsburgh, PA, USA"},{"name":"Soma Jobbagy and Simmi Patel contributed equally to this manuscript."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Marboe","sequence":"additional","affiliation":[{"name":"Columbia University College of Physicians and Surgeons, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie-Gen","family":"Jiang","sequence":"additional","affiliation":[{"name":"Rutgers\/New Jersey Medical School, Newark, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4143-4134","authenticated-orcid":false,"given":"Zsolt","family":"Jobbagy","sequence":"additional","affiliation":[{"name":"Rutgers\/New Jersey Medical School, Newark, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2015.11.009"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1885-5857(06)60675-0"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2007.11.014"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1827.1988.tb01090.x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(70)90287-5"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0003-4975(10)61765-1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.75.4.705"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(98)90194-0"},{"key":"e_1_3_2_10_2","first-page":"496","article-title":"Hamartoma of mature cardiac myocytes: a case report","volume":"11","author":"Sturtz CL","year":"1998","unstructured":"Sturtz CL, Abt AB, Leuenberger UA, Damiano R. 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