{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T06:27:10Z","timestamp":1761805630937,"version":"build-2065373602"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary pericardial schwannoma is a highly unusual tumor, and only a few cases have been reported in the literature. We report a case of giant primary pericardial schwannoma that was accurately diagnosed and managed by multimodal cardiac imaging and transesophageal endoscopic ultrasound-guided fine needle aspiration (EUS-FNA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>A 47-year-old female patient presented with complaints of exertional dyspnea and non-anginal chest pain. The patient's New York Heart Association (NYHA) functional capacity score was 2\u20133 and N-terminus pro-B type natriuretic peptide (NT-proBNP) was elevated at 684\u2005pg\/ml. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) revealed a well-circumscribed mass containing a cystic lesion, compressing the left atrium (LA) and inferior vena cava (IVC). Thoracic computed tomography (CT) angiography revealed that the lesion was intrapericardial, located in the posterior mediastinum, 10.1\u2005cm\u2009\u00d7\u20098.1\u2005cm\u2009\u00d7\u20095.2\u2005cm in size, had regular borders, and was compressing the esophagus. Magnetic resonance imaging (MRI) showed a well-circumscribed, T1-hypointense and T2-hyperintense pericardial mass. The mass was observed to have homogeneous signal intensity on T1 and T2-weighted images. CT and MRI showed that the mass did not cause myocardial involvement. Whole-body 18 F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)-CT images revealed that the mass was primary, had no metastasis, and had mild to moderate 18F-FDG avidity. Immunohistochemical evaluation with EUS-FNA determined the mass to be consistent with schwannoma, and the Ki-67 index was less than 1%. The mass was completely removed after the pericardium was opened by performing a median sternotomy approach. No residual mass was detected in the patient's follow-up. At 6-month and 1-year follow-ups, there were no symptoms, the NYHA score was 1, and NT-proBNP was normal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The integrative approach of multimodal cardiac imaging and EUS-FNA can effectively guide the surgical approach and management of primary pericardial schwannomas preoperatively. EUS-FNA may be an effective and safe method in the management of cardiac schwannomas. To our knowledge, this is the first case in which EUS-FNA has been used for the diagnosis of cardiac schwannoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2025.1688224","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T06:22:11Z","timestamp":1761805331000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal cardiac imaging and endoscopic ultrasound-guided fine needle aspiration for accurate diagnosis and management of giant primary pericardial schwannoma: a case report with literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Ali Hakan","family":"Konu\u015f","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1148\/rg.336135512","article-title":"Primary pericardial tumors","volume":"33","author":"Restrepo","year":"2013","journal-title":"Radiographics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"104","DOI":"10.4103\/2278-330X.155708","article-title":"Mediastinal schwannoma: a clinical, pathologic, and imaging review","volume":"4","author":"Kapoor","year":"2015","journal-title":"South Asian J Cancer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/s0003-4975(98)00473-1","article-title":"Successful removal of massive cardiac neurilemoma with cardiopulmonary bypass","volume":"66","author":"Hashimoto","year":"1998","journal-title":"Ann Thorac Surg"},{"key":"B4","first-page":"438","article-title":"Images in cardiovascular medicine. 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