Objective To explore the clinical and pathological features of primary cardiac hemangioma.

Methods The archived slices of primary cardiac hemangioma from 2015 to 2021 were retrospectively collected, the histopathological morphology was reviewed, the relevant medical history data, treatment process, and follow-up were analyzed.

Results A total of 23 primary cardiac hemangiomas were obtained. There were 11 males and 12 females. The age range was 17-71 years old. There were 22 cases of single lesion and 1 case of multiple lesions. Ten cases originated from the heart cavity, and 13 from the surface of the heart. The maximum diameter of the tumor is 1.0-11.3 cm. Histologically, there were 18 cases of hemangioma with mainly cavernous elements, and 4 cases with mainly capillary features. In addition, unusual cell morphology and growth patterns were seen. All patients underwent complete surgical resection and were followed up for 8-88 months. All patients survived without recurrence.

Conclusions Cardiac hemangiomas are mainly single, with insidious onset, often accompanied by pericardial effusion, and have a good prognosis. Histology is dominated by cavernous morphology, and rare morphological variants may occur, posing a potential risk of misdiagnosis.