Complex Cardiac Tumor with Concomitant Pericardial Effusion and Hemodynamic Compromise in a Septuagenarian: Case Report of Anesthetic and Surgical Considerations.

Primary cardiac tumors are rare, and cardiac lymphomas are particularly uncommon. Their presentation can mimic benign tumors, but perioperative management is highly challenging due to risks of tumor-related obstruction or invasion of surrounding cardiac structures. We present a 76-year-old woman with rapidly progressing dyspnea, found to have large biatrial masses, significant pericardial and pleural effusions, and evidence of tamponade. The patient underwent successful surgical resection of bilateral atrial tumors after careful anesthetic preparation and intraoperative monitoring. Histology revealed diffuse large B-cell lymphoma, and systemic chemotherapy was commenced. This case highlights the critical importance of multidisciplinary collaboration, preoperative hemodynamic stabilization, careful anesthetic planning, and prompt histological diagnosis in managing primary cardiac lymphoma presenting with tamponade physiology.