Thrombus or tumor? a case of fibroelastoma as indicated during the submission process

Vizzardi, Enrico; Faggiano, Pompilio; Antonioli, Elena; Zanini, Gregoriana; Chiari, Égler; Nodari, Savina; Dei, Livio

doi:10.1186/1757-1626-2-31

Cited by 6 publications

(10 citation statements)

References 13 publications

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“…The diagnosis is usually accomplished through TEE and CMR. Single CPFs are detected by TTE in 91.4% of cases, whereas multiple fibroelastomas are only detected in 8.6% (12). Small CPFs are difficult to see on TEE, CMR providing better visualization of cardiac tumors when TEE is inconclusive.…”

Section: Discussionmentioning

confidence: 99%

Transapical Left Ventricular Approach for Cardiac Papillary Fibroelastomas: A Case Report

Ştiru

Geana

Dragulescu

et al. 2020

In Vivo

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Background/Aim: Cardiac papillary fibroelastomas (CPF) are benign tumors, frequently asymptomatic, characterized by a mobile pedunculated mass that arises from the endocardium. When CPF is located in the left ventricle, it may protrude into the left ventricular outflow tract and affect hemodynamics. They are highly thrombogenic, and can also cause some life-threatening events such as cerebral and peripheral embolization. Case Report: We herein report a case of a 74-year-old female admitted to our center with palpitations and dyspnea on exertion. Her past medical history revealed that she had had a transient ischemic attack 7 months before presentation. Echocardiography and cardiac magnetic resonance imaging revealed an intracardiac mass anchored in the anteroapical interventricular septum without interference with aortic or mitral valve functionality. Surgical resection of the left ventricular mass was performed through the left apical ventriculotomy approach. Histopathological examination of the tumor was suggestive of papillary fibroelastoma. The postoperative course was uneventful. The patient was discharged home on the eighth postoperative day, with no recurrence at 6 months. Conclusion: Although left ventricular papillary fibroelastomas are benign tumors, they carry a high risk for embolic complications and therefore surgery should be proposed, the transapical approach being a safe and effective method.

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Section: Discussionmentioning

confidence: 99%

Transapical Left Ventricular Approach for Cardiac Papillary Fibroelastomas: A Case Report

Ştiru

Geana

Dragulescu

et al. 2020

In Vivo

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“…Although it usually affects cardiac valves, it is rarely related to valve dysfunction. Although infrequent, fibroelastoma can also affect other sites, such as tendinous cords, the endocardium, and papillary muscles [ 2 , 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Fibroelastoma presents as a single lesion that is small (less than 10 mm), not vascularized, and mobile, and it has a sea anemone-like appearance [ 4 ]. It more commonly affects the aortic valve, followed by the mitral, tricuspid, and pulmonary valves [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Mitral Valve Papillary Fibroelastoma as the Cause of Ischemic Stroke in a Young Patient: A Case Report

et al. 2021

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Patient: Female, 27-year-old Final Diagnosis: Ischemic stroke • papillary fibroelastoma Symptoms: Motor aphasia and hemiparesis in the right dimidium Medication:— Clinical Procedure: — Specialty: Cardiology • Neurology Objective: Rare disease Background: Primary cardiac tumors represent less than 5% of total cardiac tumors. Fibroelastoma is a rare benign cardiac tumor that is usually asymptomatic but is acknowledged for its emboligenic potential for causing cardiac, neurological, and vascular symptoms and increasing patient morbidity and mortality. Case Report: This report describes the clinical case of a 27-year-old woman who entered the Emergency Department with motor aphasia and hemiparesis in the right dimidium. A brain computed tomography scan was performed at admission, which showed left frontal-parietal hypodensity. The diagnosis of ischemic stroke was made, but cerebral reperfusion therapy with intravenous recombinant tissue plasminogen activator was not instituted due to the time that had passed since ictus (15 h 40 min). On the first day of hospitalization, the patient had a fever, with no apparent infectious cause. She underwent transthoracic echocardiogram that showed a sessile, isoechoic mass adhered to the atrial surface of the anterior mitral valve leaflet, measuring 6.8×5.5 mm. Antibiotic therapy with ceftriaxone and gentamicin was initiated due to the initial diagnosis of infective endocarditis. Three blood culture samples had negative results. Given a differential diagnosis of fibroelastoma, transesophageal echocardiography and cardiac resonance imaging were performed, and the findings were compatible with a diagnosis of mitral valve fibroelastoma. After clinical discussion, the patient was referred to cardiac surgery and underwent tumor resection with anatomopathological diagnosis of papillary fibroelastoma of the heart valve. Conclusions: Young patients with ischemic stroke must be investigated with transthoracic and transesophageal echocardio-grams. Papillary fibroelastoma is potential cause of ischemic stroke in young patients, and surgical resection is curative and has excellent prognosis.

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“…They have multiple papillary fronds resembling sea anemones. Since the symptoms may mimic other conditions and the fibroelastoma has a similar echocardiographic appearance to thrombus and other various types of cardiac mass, the tumor may be not considered as a diagnosis or it may erroneously be regarded as a thrombus, vegetation, or degenerative valve tissue [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac Fibroelastoma: A Rare Cause of Stroke in Young Adults

Mirdamadi

Mirmohammadsadeghi

Arasteh

et al. 2013

Case Reports in Cardiology

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A 26-year-old man presenting with a transient episode of dysarthria and dizziness, 3 weeks prior to admission, was referred to our center to be evaluated for transient ischemic attack (TIA). The patient had been previously admitted to a different hospital and echocardiography was reported normal at that center, but upon presenting to our institution strand-like masses in the left ventricle (LV) were detected. Transesophageal echocardiography (TEE) revealed two distinct mobile LV masses suggesting a diagnosis of papillary fibroelastoma. CT angiography and histopathological studies confirmed this diagnosis.

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Thrombus or tumor? a case of fibroelastoma as indicated during the submission process

Cited by 6 publications

References 13 publications

Transapical Left Ventricular Approach for Cardiac Papillary Fibroelastomas: A Case Report

Transapical Left Ventricular Approach for Cardiac Papillary Fibroelastomas: A Case Report

Mitral Valve Papillary Fibroelastoma as the Cause of Ischemic Stroke in a Young Patient: A Case Report

Cardiac Fibroelastoma: A Rare Cause of Stroke in Young Adults

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