Papillary fibroelastoma of the aortic valve

  • Filip Vukmirović Department of Pathology, Clinical Center of Montenegro, Podgorica, Montenegro
  • Mihailo Vukmirović Department of Cardiology, Clinical Center of Montenegro, Podgorica, Montenegro
  • Irena Tomašević Vukmirović Department of Radiology, Clinical Center of Montenegro, Podgorica, Montenegro
Keywords: heart neoplasms, fibroma, aortic valve, diagnosis, echocardiography, histological techniques,

Abstract


Introduction. Primary tumors of the heart are rare, usually benign and occur mostly in adults, and usually originate from the endocardium, followed by the myocardium and rarest of the pericardium. Papillary fibroelastoma accounts for less than 10% of all cardiac tumors, but they are most common valvular tumors. The clinical presentation of papillary fibroelastoma varies from asymptomatic cases to cases which have severe clinical presentation that is most likely due to embolic complications. Tumor can usually be discovered by echocardiography or during autopsy. Case report. We reported a case of 53-year-old man submitted to routine echocardiographic examination. The patient had the history of hypertension for five years, without any other symptoms. Echocardiography found a round tumor attached to the noncoronary cuspis of the aortic valve. The tumor was surgically removed and pathohistological examination confirmed diagnosis of papillary fibroelastoma. After surgery the patient fully recovered without tumor recurrence or aortic regurgitation. Conclusion. Histologically, papilary fibroelastoma is benign tumor of the heart. As demonstrated in this case, a papillary fibroelastoma can be an incidental finding discovered during echocardiography in patients with the history of hypertension.

References

Grande AM, Ragni T, Viganò M. Primary cardiac tumors. A clinical experience of 12 years. Tex Heart Inst J 1993; 20(3): 223−30.

Boodhwani M, Veinot JP, Hendry PJ. Surgical approach to cardiac papillary fibroelastomas. Can J Cardiol 2007; 23(4): 301−2.

Burke A, Jeudy J, Virmani R. Cardiac tumours: an update: car-diac tumours. Heart 2008; 94(1): 117−23.

Rafajlovski S. Tumors of the heart. Belgrade: Military Medical Academy; 2010. (Serbian)

Peters PJ, Reinhardt S. The echocardiographic evaluation of intracardiac masses: a review. J Am Soc Echocardiogr 2006; 19(2): 230−40.

Gopaldas RR, Atluri PV, Blaustein AS, Bakaeen FG, Huh J, Chu D. Papillary fibroelastoma of the aortic valve: operative ap-proaches upon incidental discovery. Tex Heart Inst J 2009; 36(2): 160−3.

Klarich KW, Enriquez-Sarano M, Gura GM, Edwards WD, Tajik AJ, Seward JB. Papillary fibroelastoma: echocardiographic cha-racteristics for diagnosis and pathologic correlation. J Am Coll Cardiol 1997; 30(3): 784−90.

Bossert T, Gummert JF, Battellini R, Richter M, Barten M, Walther T, et al. Surgical experience with 77 primary cardiac tumors. Interact Cardiovasc Thorac Surg 2005; 4(4): 311−5.

Parthenakis F, Nyktari E, Patrianakos A, Pitsis A, Asimaki A, Vardas P. Asymptomatic papillary fibroelastoma of the aortic valve in a young woman – a case report. Cardiovasc Ultra-sound 2009; 7: 43.

Yamaguchi M, Yagi K, Ikeya E, Fujimura T, Taguchi J, Shibuya M, et al. A case report of papillary fibroelastoma attached to chorda tendineae of mitral valve. Tokai J Exp Clin Med 2006; 31(2): 56−9.

Grinda JM, Couetil JP, Chauvaud S, Attellis DN, Berrebi A, Fabiani JN, et al. Cardiac valve papillary fibroelastoma: surgical exci-sion for revealed or potential embolization. J. Thorac Cardio-vasc Surg 1999; 117(1): 106−10.

Sato Y, Yokoyama H, Satokawa H, Takase S, Maruyama Y. A re-port of a surgical case of papillary fibroelastoma in the left ventricular outflow tract. Ann Thorac Cardiovasc Surg 2003; 9(4): 270−3.

Gowda RM, Khan IA, Mehta NJ, Gowda MR, Gropen TI, Dogan OM, et al. Cardiac papillary fibroelastoma originating from pulmonary vein-a case report. Angiology 2002; 53(6): 745−8.

Matsumura Y, Sasaki T, Hashimoto K, Hachiya T, Onoguchi K, Ta-kakura H. Left ventricular papillary fibroelastoma associated with chief complaints of palpitation, general fatigue, and feve-rish. Kyobu Geka 2003; 56(9): 793−6. (Japanese)

Edwards FH, Hale D, Cohen A, Thompson L, Pezzella AT, Virmani R. Primary cardiac valve tumors. Ann Thorac Surg 1991; 52(5): 1127−31.

Xu BJ, Xie XY, Tan LH, Shu Q. Papillary Fibroelastoma of the Tricuspid Valve in a 1-mo-Old Child. Indian J Pediatr. 2013; 80 (4): 353–4.

Kurup AN, Tazelaar HD, Edwards WD, Burke AP, Virmani R, Klarich KW, et al. Iatrogenic cardiac papillary fibroelastoma: a study of 12 cases (1990 to 2000). Hum Pathol 2002; 33(12): 1165−9.

Gowda RM, Khan IA, Nair CK, Mehta NJ, Vasavada BC, Sacchi TJ. Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases. Am Heart J 2003; 146(3): 404−10.

de Feo M, Dialetto G, Oria VD, Pepino P, Giordano S, Cotrufo M, et al. Environmental pollution as a cause of papillary fibroelas-toma: hints for a new etiological hypothesis. Heart Surg Forum 2011; 14(4): E269−70.

Mendes LC, Melo NJ, Souza JB, Correia EB, Zamorano M, Silva LM. Papillary fibroelastoma: report of seven cases. Arg Bras Cardiol; 2012; 98(3): e59−61.

Haron H, Yusof MR, Maskon O, Ooi J, Rahman MR. Tricuspid valve papillary fibroelastoma: a rare tumor with a diagnostic di-lemma. Heart Surg Forum 2012; 15(1): E59−61.

Albuquerque LC, Trindade VD. Heart valve papillary fibroelas-toma associated with cardioembolic cerebral events. Rev Bras Cir Cardiovasc 2011; 26(4): 670−2.

Bicer M, Cikirikcioglu M, Pektok E, Müller H, Dettwiler S, Kalangos A. Papillary fibroelastoma of the left atrial wall: a case report. J Cardiothorac Surg 2009; 4: 28.

Grandmougin D, Fayad G, Moukassa D, Decoene C, Abolmaali K, Bodart JC, et al. Cardiac valve papillary fibroelastomas: clinical, histological and immunohistochemical studies and a physiopa-thogenic hypothesis. J Heart Valve Dis 2000; 9(6): 832−41.

Anastacio MM, Moon MR, Damiano RJ, Pasque MK, Maniar HS, Lawton JS. Surgical experience with cardiac papillary fibroelas-toma over a 15-year period. Ann Thorac Surg 2012; 94(2): 537−41.

Published
2015/04/23
Section
Case report