Tumors and tumor-like lesions of the heart valves

Abstract

Valvular tumors and tumor-like lesions may have similar morphological and clinical characteristics, and may place the patients at a high risk of stroke in different ways. From January 2004 to June 2008, 11 patients underwent surgery for a suspected valvular tumor. Valvular tumor and tumor-like lesions accounted for 0.32% of adult cardiac operations. Five (45.5%) valvular lesions were papillary fibroelastomas, one (9.1%) was myxoma, 2 (18.2%) were organized thrombi, and 3 (27.3%) were calcification lesions. There was a total of 5 (45.5%) atrioventricular valve lesions, 4 arising from the atrial side of the leaflets, and one from the ventricular side. All 5 (45.5%) semilunar valvular lesions were from the aortic valve. One (9.1%) lesion originated from the chorda tendinea of the mitral valve. All leaflet lesions were resected by a simple shave technique, and all the patients recovered favorably. Valvular tumor and tumor-like lesions are rare. Pre-operative differential diagnoses among these valvular lesions pose important clinical implications for appropriate treatment for the underlying diseases. Prompt therapeutic measures in view of the underlying diseases of the valvular lesions are essential to prevent potential embolic events.

Unusual aspects of cardiac myxoma

“…Some reports have described tumor recurrence, local invasion, peripheral tumor mass, or distant metastasis of cardiac myxomas ( 45 ). Cardiac papillary fibroelastomas and intracardiac thrombus are often valvular ( 43 , 46 , 47 ). The cavernous hemangiomas are isointense masses on magnetic resonance imaging ( 43 , 48 ).…”

Innocent left ventricular outflow tract membrane masquerading as vegetation

“…Fibroelastomas are lobulated, oval to round and irregular,2 mostly attached to the valves (aortic valve being the most common) and only 16% are attached to the non-valvular surface of endocardium 3. Discrete subaortic stenosis presents as fibromuscular band and it progressively causes obstruction and increased transvalvular gradient 4.…”

Cavernous haemangioma of anterior mitral valve leaflet: diagnostic utility of 3D echocardiography

“…The differential diagnosis for cardiac valvular masses includes tumours, thrombus and vegetations. Papillary fibroelastoma is the most common primary valvular tumour, although only 16% of these involve the mitral valve 1. Papillary fibroelastomas are generally smaller than 1 cm, attached to the heart via a short stalk and highly mobile, thus making them readily diagnosable via echocardiography 1.…”

“…Papillary fibroelastoma is the most common primary valvular tumour, although only 16% of these involve the mitral valve 1. Papillary fibroelastomas are generally smaller than 1 cm, attached to the heart via a short stalk and highly mobile, thus making them readily diagnosable via echocardiography 1. Cardiac myxomas are the most common primary cardiac tumour, although only 8.8% of these involve a valve.…”

“…Advanced degenerative or myxomatous disease can sometimes by mistaken for a valvular mass. Endocarditis and valvular vegetations or abscesses have a variety of appearances and are sometimes only confirmed operatively 1. Acute and healed endocarditis can result in a wide spectrum of mitral valve pathology including chordal rupture, leaflet vegetations and annular abscesses 8.…”