Incidental tricuspid valve fibroelastoma associated with patent foramen ovale in a young female: Straightforward diagnosis but controversial management

Abstract

Papillary fibroelastoma is an uncommon primary cardiac tumor, predominantly associated with left-sided valvular endocardium. Affectation of tricuspid valve leaflets is rare, and management in asymptomatic patients remains controversial. We present a 30-year-old female referred for evaluation prior to bariatric surgery. A routine echocardiogram revealed a mobile cardiac mass attached to the tricuspid valve. A patent foramen ovale was also present. Tumor was surgically removed. Histology confirmed the definite diagnosis of a papillary fibroelastoma. In our case, the presence of a patent foramen ovale associated with the right-sided fibroelastoma was decisive in the decision for surgery.

A mobile mass on the tricuspid valve in a young female: The critical distinction between the vegetation and cardiac tumor

“…An accurate diagnosis and distinction from other intracardiac masses is essential because they are a potential cause of systemic emboli, stroke, myocardial infarction and sudden death. 1,2 We report a case of a woman presenting with a history considering infective endocarditis, who was found to have PFE arising from the tricuspid valve.…”

“…PFE MRI features include isointense T1--imaging and hyperintense T2-imaging. [1][2][3][4] The management of PFE depends upon its clinical presentation. Patients who are experiencing embolic events that are cardiovascular or neurologic in origin should undergo surgical resection.…”

“…PFEs are not causally associated with valve dysfunction. 1,2 Although the ethiopathogenesis of PFE is unknown, various possible causes have been suggested in the literature. They have been considered as hamartomas, organized thrombi, true neoplasms or infl ammatory foci due to unusual endocardial responses to infection or hemodynamic trauma.…”