A rare nonvalvular left ventricular papillary fibroelastoma: A case report

Forum D Kamdar, Sithu Win, J. Carlos Manivel, Sara J Shumway, Emil Missov

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Papillary fibroelastomas are benign cardiac tumors with high embolic potential typically found on the valvular surfaces of the heart. Nonvalvular papillary fibroelastomas are exceedingly rare. We report the case of a 66-year-old Caucasian male with acute bilateral basal ganglia infarctions found to have a mass adherent to the left ventricular septum by transesophageal echocardiography. The mass was identified as a rare nonvalvular cardiac papillary fibroelastoma based on echogenicity, pedunculated nature, and typical motion. Tissue characterization by cardiac magnetic resonance imaging demonstrated homogeneously hypo-intense signal on T2 weighted imaging and signal hyperintensity after administration of gadolinium contrast, confirming the fibroelastic nature of the mass. Surgical excision was performed via ventriculotomy and histopathologic examination was pathognomonic of a papillary fibroelastoma. We conclude that transesophageal echocardiography provides high diagnostic certainty in patients with cardiac papillary fibroelastomas and can reliably identify atypical locations of these tumors on nonvalvular surfaces. A multimodality imaging approach is not necessarily indicated in all patients with this condition.<. Learning objective: Papillary fibroelastomas are benign cardiac tumors with high embolic potential typically found on the valvular surfaces of the heart. Nonvalvular papillary fibroelastomas are exceedingly rare. Transesophageal echocardiography readily identifies nonvalvular papillary fibroelastomas based on echogenicity, pedunculated nature, and characteristic motion, and reliably differentiates them from other cardiac masses. A multimodality imaging approach is not indicated in all patients with this condition.>.

Original languageEnglish (US)
Pages (from-to)8-10
Number of pages3
JournalJournal of Cardiology Cases
Volume9
Issue number1
DOIs
StatePublished - Jan 2014

Keywords

  • Cardiac magnetic resonance imaging
  • Nonvalvular
  • Papillary fibroelastoma
  • Transesophageal echocardiography

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