Cardiac papillary fibroelastoma. Experience of an institution

Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP.
Arquivos Brasileiros de Cardiologia (Impact Factor: 1.02). 10/2005; 85(3):205-7. DOI: 10.1590/S0066-782X2005001600010
Source: PubMed


Primary intracardiac tumors are rare, with prevalence between 0.0017% and 0.19% from non-selected autopsy studies. Approximately 75% are benign and almost half of them are myxomas. The remaining tumors are divided among rhabdomyomas, lipomas and fibroelastomas. Myxomas are the most common intracardiac tumors in adult age and rhabdomyomas the most common among pediatric population. Papillary fibroelastoma (PFE) is a relative rare benign heart tumor, corresponding to approximately 8% of intracardiac tumors. They most commonly manifested in cardiac valves. In the past, they either consisted of necropsy findings or were found in surgical procedures at random. In vivo diagnosis was sporadic. With the improvement of echocardiography techniques, PFE has been more frequently diagnosed. They are usually described as a movable, pedunculate, well-delimited mass and with predilection for valve endocardium. Therapeutic proposal, when they are pedunculate, is surgical resection, preventing cerebral, pulmonary, coronary or peripheral embolic phenomena. Five cases diagnosed in our institution, in the period from August 1995 to June 2004, will be presented.

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Available from: Fábio Fernandes, Dec 08, 2014
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    ABSTRACT: Cardiac papillary fibroelastoma is a rare benign tumor of the heart mostly involving the valves or left sided chambers. It is often diagnosed during evaluation for other pathologies. It may produce symptoms due to its location or embolisation of the tumor itself or superimposed thrombus. It is therefore advisable to excise this tumor to prevent the catastrophic effects of systemic, pulmonary or paradoxical embolism.
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    ABSTRACT: We describe a case of cardiac papillary fibroelastoma in a 33-year-old man. The diagnosis was established by echocardiography. Computerised tomographic angiography gave no evidence of coronary stenosis, but illustrated a radiopaque filling defect in the left ventricle. The papillary fibroelastoma was removed together with the involved chorda, and an artificial chord was implanted under cardiopulmonary bypass. Histological study confirmed the diagnosis of papillary fibroelastoma. Due to the potentials of cerebral and coronary embolisation, surgical management to the patients with a papillary fibroelastoma is highly recommended.
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