{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T09:47:53Z","timestamp":1779356873098,"version":"3.51.4"},"reference-count":9,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:p>Cardiac masses are difficult to diagnose in the pediatric population, especially in the setting of systemic symptoms. Although multiple imaging modalities are available to characterize cardiac masses, it is important to consider a different diagnostic approach in the setting of recurrent cardiac masses and nonspecific systemic symptoms. We present a case involving a previously healthy adolescent with multiple hospitalizations because of persistent fevers, cachexia, and recurrent cardiac masses. Echocardiography and cardiac computed tomography imaging suggested endocarditis, but the patient failed to respond to multiple intravenous antibiotic treatments. He developed recurrent cardiac masses in the right atrium and right ventricle that were debulked and biopsied. The biopsy did not yield a conclusive diagnosis. The patient returned to the hospital with hemoptysis and large pulmonary pseudoaneurysms that had to be occluded during cardiac catheterization. Given his constellation of symptoms and improvement with steroids during surgical procedures, he was ultimately diagnosed with a variant of Behcet\u2019s disease known as Hughes-Stovin syndrome. His symptoms resolved completely with steroids and immunosuppression therapy. Our report reveals the limitations of the standard diagnostic approach toward cardiac masses and the importance of considering response to treatment as a clue to the etiology of an unusual cardiac mass.<\/jats:p>","DOI":"10.1542\/peds.2023-062122","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T08:11:20Z","timestamp":1697616680000},"source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic Approach to Recurrent Intracardiac Masses That Present With Systemic Symptoms"],"prefix":"10.1542","volume":"152","author":[{"given":"Sanghee S.","family":"Ro","sequence":"first","affiliation":[{"name":"aEmory University School of Medicine, Atlanta, Georgia"},{"name":"bChildren\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sassan","family":"Hashemi","sequence":"additional","affiliation":[{"name":"bChildren\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fawwaz","family":"Shaw","sequence":"additional","affiliation":[{"name":"aEmory University School of Medicine, Atlanta, Georgia"},{"name":"bChildren\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Slesnick","sequence":"additional","affiliation":[{"name":"aEmory University School of Medicine, Atlanta, Georgia"},{"name":"bChildren\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"2023110103014830900_B1","first-page":"1432","volume-title":"Heart Disease in Infants, Children and Adolescents, Including the Fetus and Young Adult","author":"Marx","year":"2001"},{"issue":"4","key":"2023110103014830900_B2","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1086\/313753","article-title":"Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis","volume":"30","author":"Li","year":"2000","journal-title":"Clin Infect Dis"},{"issue":"9","key":"2023110103014830900_B3","doi-asserted-by":"crossref","first-page":"1204.e5","DOI":"10.1016\/j.cjca.2015.04.009","article-title":"Behcet\u2019s disease presenting with cardiac and pulmonary masses","volume":"31","author":"Ng","year":"2015","journal-title":"Can J Cardiol"},{"key":"2023110103014830900_B4","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1750-1172-6-15","article-title":"Hughes-Stovin syndrome","volume":"6","author":"Khalid","year":"2011","journal-title":"Orphanet J Rare Dis"},{"issue":"4","key":"2023110103014830900_B5","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S1051-0443(07)61897-1","article-title":"SCVIR annual meeting film panel session: diagnosis and discussion of case 1: Hughes-Stovin syndrome","volume":"12","author":"Weintraub","year":"2001","journal-title":"J Vasc Interv Radiol"},{"issue":"12","key":"2023110103014830900_B6","doi-asserted-by":"crossref","first-page":"4787","DOI":"10.1007\/s10067-021-05958-3","article-title":"Hughes-Stovin syndrome (HSS): current status and future perspectives","volume":"40","author":"Sanduleanu","year":"2021","journal-title":"Clin Rheumatol"},{"issue":"5","key":"2023110103014830900_B7","first-page":"e7907","article-title":"Hughes Stovin syndrome, a rare form of Behcet\u2019s disease presenting as recurrent intracardiac thrombus","volume":"12","author":"B K","year":"2020","journal-title":"Cureus"},{"issue":"2","key":"2023110103014830900_B8","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/0146-2806(92)90025-J","article-title":"Cardiac tumors: diagnosis and management","volume":"17","author":"Salcedo","year":"1992","journal-title":"Curr Probl Cardiol"},{"issue":"1","key":"2023110103014830900_B9","doi-asserted-by":"crossref","first-page":"e007829","DOI":"10.1161\/JAHA.117.007829","article-title":"Assessment of cardiac masses by cardiac magnetic resonance imaging: histological correlation and clinical outcomes","volume":"8","author":"Mousavi","year":"2019","journal-title":"J Am Heart Assoc"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2023-062122\/1548651\/peds.2023-062122.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2023-062122\/1548651\/peds.2023-062122.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T03:02:34Z","timestamp":1698807754000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/152\/5\/e2023062122\/194419\/Diagnostic-Approach-to-Recurrent-Intracardiac"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,18]]},"references-count":9,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,10,18]]},"published-print":{"date-parts":[[2023,11,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2023-062122","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,18]]},"article-number":"e2023062122"}}