A 29yearold asymptomatic young woman with incidental transthoracic echocardiographic tte discovery. Their most common location is the aortic valve, followed by the mitral and tricuspid valves, pulmonary valve, and endocardial surfaces. A 52yearold woman complained of palpitations and echocardiography revealed a cardiac tumor. T1 surgical treatment of cardiac papillary fibroelastoma. However, as a consequence of increased imaging examinations, incidental pfe may represent the most common cardiac tumor. The topic papillary fibroelastoma of heart you are seeking is a synonym, or alternative name, or is closely related to the medical condition papillary fibroelastoma. The papillary fibroelastoma pfe is a rare and benign primary cardiac tumor.
The mobility and the size, 20 mm in diameter, of the tumor indicated the need to perform surgical treatment. Papillary fibroelastoma pfe is a rare primary cardiac neoplasm that is usually. Case surgical treatment of papillary fibroelastoma in the. Article information, pdf download for papillary fibroelastoma found with.
Papillary fibroelastomas are rare benign primary cardiac tumors that usually grow depending on the left heart valves. Primary cardiac tumors are very rare, papillary fibroelastoma pfe being the second most common benign tumor of the heart in previous series. Multimodality imaging of a papillary fibroelastoma of the tricuspid valve case report adela serban1,2, nicoleta batrana1. Papillary fibroelastomas are rare benign primary cardiac tumors. We performed 3 distal coronary anastomoses and then made an oblique aortotomy to expose the aortic valve. Introducere fibroelastomul papilar este cea mai frecvent a tumor a cu localizare valvular a. Papillary fibroelastoma of the aortic valve and coronary. Transthoracic echocardiography tte performed at 78 years of age revealed a mass attached to the noncoronary cusp and a cardiac tumor was suspected. Case presentation multimodality imaging of a papillary. Cardiac papillary fibroelastoma presenting as chorea in childhood. This is a movie clip, demonstrating the classical echocardiographic picture of the papillary fibroelastoma of the aortic valve. Echocardiographic diagnosis of papillary fibroelastoma of the. Papillary fibroelastoma found with transesophageal.
However, it is the most common tumor occurring in cardiac valves. Papillary fibroelastoma is a benign tumor of the heart valves that can occur in children and adults. Fibroblastoma definition of fibroblastoma by medical. The clinical manifestations of this entity are not well described. A soft, gelatinous, 1cm mass was found adhering to the free edge of the left coronary cusp of the aortic valve fig. A 64 year old woman presented with right hemianaesthesia and was found to have a pansystolic apical murmur with systolic and diastolic posture related plops. Incidental papillary fibroelastoma of the tricuspid valve. Of the reports of pfe in childhood, the majority of cases. Cardiac papillary fibroelastoma the annals of thoracic surgery. Most tumors are asymptomatic, but when present, they are nonspecific or related to embolic phenomena.
Papillary fibroelastoma arising from left ventricular. In 1975, while at armed forces institute of pathology, our colleague melvin cheitlin and his group appear to have been the first to publish the term papillary fibroelastoma in a. They are the third most common type of primary tumor of the heart, behind cardiac myxomas and cardiac lipomas. Myxomas typically arise in the left atrium 80% with fewer 20% arising in the right atrium. We herein, present a 50yearold female patient with a papillary fibroelastoma of the aortic valve arising from the endocardium of the right coronary cusp very close to the commissure between the right and noncoronary cusps. They are usually diagnosed at routine imaging studies or valve surgery and autopsies. Additionally, the signs and symptoms of stroke due to thromboemboli may be present. Cmr findings of the pulmonary valve mass were most consistent with the diagnosis of a pulmonary valve papillary fibroelastoma pfe. The second most common type of cardiac tumor in adults is the fibroelastoma figure 1, also known as cardiac papillary fibroelastoma cpf. Papillary fibroelastoma is a rare benign cardiac tumor that usually arises from the valvular endocardium and its development in the cardiac chambers is extremely rare.
This was successfully excised and was proven on histopathological examination to be a fibroelastoma. Contrastenhanced cmr permits accurate differentiation of thrombus and cardiac tumors. Their clinical presentation varies from incidental asymptomatic masses to severe lifethreatening cardiovascular complications. Papillary fibroelastoma is a rare benign cardiac tumor that usually arises from the valvular endocardium and its development in the cardiac. Through a right atriotomy, the tumor with multiple. Pdf papillary fibroelastoma of the aortic valve in association with. Among cardiac tumors, cardiac papillary fibroelastomas pfes are extremely rare. Grossly, the papillary fibroelastoma has been compared to a sea anemone, an appearance heightened by placing the specimen in a bowl of water figure 19. Papillary fibroelastomas are the second most common cardiac tumor.
Papillary fibroelastoma of the heart radiology reference. Papillary fibroelastoma of the right ventricular free wall. An 80yearold woman with a history of congestive heart failure, atrial fibrillation, and hypertension was transferred to our institution with hematemesis. Papillary fibroelastomas, while considered generally rare, make up about 10 percent of all primary tumors of the heart. Papillary fibroelastoma of the tricuspid valve springerlink. The clinical presentation of papillary fibroelastoma varies from. The diagnostic related groups drgs are a patient classification scheme which provides a means of relating the type of patients a hospital treats.
Also called giant lambl excrescence 8 10% of all heart tumors. Papillary fibroelastoma of the right ventricular free wall ncbi. Papillary fibroelastoma pfe is a rare primary benign tumor of cardiac origin that predominantly affects the cardiac valves. Cardiac papillary fibroelastoma cpf is a primary cardiac neoplasm that is increasingly detected by echocardiography. Here is an account of how the problem was detected and treated in a 75yearold male. Papillary fibroelastoma an overview sciencedirect topics. The papillary fibroelastoma pfe is a benign heart tumor, mainly found in the valves. Papillary fibroelastoma on the pulmonary valve in a young woman. In 1975, while at armed forces institute of pathology, our colleague melvin cheitlin and his group appear to have been. Two cases of atypical presentation of papillary fibroelastoma. Aortic valve papillary fibroelastoma associated with acute. A diagnosis of papillary fibroelastoma may be undertaken using the following tests and exams.
Resection was performed via the right ventricle and main pulmonary artery under cardiopulmonary bypass. C j coats, j reid, s wright, p sonecki, n alattar, papillary fibroelastoma arising from left ventricular outflow tract, european heart journal cardiovascular imaging, volume 19, issue 7, july 2018. The mass was a pedunculated, mobile, round, echo dense, and stipple in texture structure, with welldemarcated borders, features typical of a fibroelastoma. The prevalence of primary cardiac tumour ranges from 0. Neither tricuspid obstruction nor regurgitation was observed. A rare tumor and rare location hatim yagoub, mbbs, msc, 1 abdullah sayied abdullah, mbbs, mrcpi, 1 abdalla ibrahim, mbbs, 1 brendan meany, mrcpi, 1 peter faul, mb, 2 thomas j. We describe a case of a 43yearold caucasian female post ami diagnosed with a midcavitary mass. A rare location and presentation of papillary fibroelastoma. Echocardiographic characteristics for diagnosis and pathologic correlation, journal of the american college of cardiology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. The most common benign heart tumor in adults is a myxoma. Papillary fibroelastoma of the aortic valve a case.
Multimodality cardiac imaging of a left ventricular. Pdf papillary fibroelastoma of the anterior leaflet of the mitral. Pulmonary valve papillary fibroelastoma in an asymptomatic young patient author. However, of the primary cardiac tumors, they are one of the commonest to occur in relation to the cardiac valves may account for 75% of valvular tumors 10. Papillary fibroelastoma mimicking vegetation of the mitral. Echocardiography revealed a mobile mass on the mitral valve apparatus that was confirmed by magnetic resonance imaging. We dissected the mass from the edge of the valve, ensuring that no tumor was left behind on the leaflet. Her drug regimen included 2 mg warfarin potassiumday to prevent thromboembolic events. T2 a single center experience with eightyeight patients. Currently, with the advent of higherresolution imaging technology especially transoesophageal echocardiography such cases being recognized frequently.
Echocardiography represents an invaluable diagnostic tool for the detection of intracardiac masses while simultaneously provides information about their size, location, mobility and attachment site as well as the presence and extent of any consequent hemodynamic derangement. Papillary fibroelastoma is the third most common primary tumor of the heart and is most likely to involve the cardiac valves. Could you give me a little information on what this is, including the treatment and prognosis. The clinical presentation of these tumours varies from asymptomatic to severe. A case report naoki washiyama, md, phd, katsushi yamashita, md, phd, hitoshi terada, md, phd. A 72yearold male patient was admitted with chest oppression. The papillary fibroelastoma pfe is a rare and benign.
Papillary fibroelastoma of the aortic valve papilarni fibroelastom aortnog zaliska. Since the introduction of echocardiography, the diagnosis of these tumors in living patients has been reported sporadically. Papillary fibroelastoma commonly affects the aortic valve or the mitral valve. In the setting of an acute myocardial infarction ami, although the most common etiology of a left ventricular lv mass identified on multimodality cardiovascular imaging is a thrombus, other possibilities including a vegetation or tumor should be entertained within the differential diagnosis. Papillary fibroelastoma is a rare cardiac lesion, mostly encountered as an incidental finding at the time of autopsy but occasionally seen during life. A papillary fibroelastoma is a primary tumor of the heart that typically involves one of the valves of the heart.
Pulmonary valve papillary fibroelastoma in an asymptomatic. Papillary fibroelastoma is the third most common primary benign cardiac tumor typically found on the endocardium of heart valves, most often leftheart ones. Echocardiography disclosed a mobile tumor which was located on the atrial side of the tricuspid valve. Surgical treatment of cardiac papillary fibroelastoma. Kiernan, md 1 1 cardiology department, university hospital limerick, ireland. Papillary fibroelastomas are rare cardiac tumors, but they are the most common. Although this condition generally is asymptomatic, a few cases had been associated with clinical problems, such as embolic phenomena, angina pectoris, outflow tract obstruction, and sudden death. Papillary fibroelastomas are small, frondlike, often stalked intracardiac tumors known for their embolic potential. I am an 83yearold woman on warfarin because of atrial fibrillation, and i recently was diagnosed with a fibroelastoma. The clinical presentation of these tumours varies from asymptomatic to severe ischaemic or embolic complications. Papillary fibroelastoma originating from the free left ventricular wall.