Assessment of Papillary Fibroelastoma of the Semilunar Valves by Three-Dimensional Echocardiography

Abstract

Papillary fibroelastoma is an uncommon tumor. Recognitions of this tumor have been improved thanks to modern imaging advances, which have made more patients to be identified, but at the same time, the management of this disease is still controversial. There aren't enough studies to basic clinical actions. We present 2 interesting cases involving the semilunar valves. The purpose of presenting these cases is to review this rare disease and the superiority of the three-dimensional echocardiography in their diagnosis. KeywordsHeart Tumor, Papillary Fibroelastoma, Pulmonary Valve, Aortic Valve, Echocardiography BackgroundThe valvular papillary fibroelastoma is an uncommon primary cardiac tumor, ranging from 0.002% to 0.02% in prevalence, [1] [2]. Papillary fibroelastoma is the third most common primary cardiac tumor (after myxoma and lipoma), accounting for 7% to 9% of benign primary tumors. Previous studies have shown that papillary fibroelastoma has predilection for left heart valves (ninety-five percent of these tumors arise from; aortic valve-44.5% more than mitral valve-36.4%). Papillary fibroelastoma that affects the right heart is unusual and when it is seen, the pulmonary valve is affected less often than the tricuspid valve and accounts for 8% of cardiac papillary fibroelastomas [1]. The incidence of papillary fibroelastoma of the pulmonary valve is reported in Klarich KW et al. in 1997 to be between 0.00017% and 0.033% at autopsy and 0