Heart Diverticulum
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Case: Small incidental left ventricular diverticulum
A carrier approached Munich Re regarding the insurability of a 56-year-old male with a challenging heart history seeking $10,000,000 in coverage. We were asked “The proposed insured appears to be stable. Significant cardiac workup has been mostly negative with the exception of a small incidental left ventricular diverticulum described as muscular and not fibrous. It looks to have been stable for at least three years. We do not know what the rate or concern of rupture is or what treatment is available. Is this insurable?”
Copies of the cardiac imaging were not provided but the client included a nice summary of his clinical records which included summaries of prior cardiac test results.
Munich Re medical's response
What exactly is a “serous cystadenoma” of the pancreas?
- Serous cystic neoplasms (SCNs) or serous cystadenomas are non-mucinous lesions with characteristic findings on imaging. They are multi-cystic with a honeycomb appearance, sometimes described as a “bunch of grapes.” Most commonly seen in women over 60 years old, these lesions have a negligible risk for malignancy.
How common is this condition, and what are some mortality and morbidity concerns?
- Pancreatic cystic neoplasms are being detected more frequently and are mostly found incidentally due to the widespread use of abdominal imaging such as CT scans or MRIs.
- These cystic neoplasms of the pancreas are further subcategorized as either “mucin-producing cysts” (which may have malignant potential) or “non-mucin-producing cysts.”
- Mucin-producing cysts, such as intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, may have malignant potential and must be monitored carefully.
- Serous cystadenomas are in the non-mucin-producing cyst category and are considered benign with no malignant potential.