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2.
Kyobu Geka ; 77(3): 222-225, 2024 Mar.
Article in Japanese | MEDLINE | ID: mdl-38465496

ABSTRACT

We experienced a case of papillary fibroelastoma of aortic valve, which had been located for preoperative 12 years without any symptom. We could assess tumor growth rate of 0.17 mm/year. Because of recent reports of recurrence, close follow-up should be continued.


Subject(s)
Cardiac Papillary Fibroelastoma , Fibroma , Heart Neoplasms , Humans , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Cardiac Papillary Fibroelastoma/pathology , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/surgery , Fibroma/diagnostic imaging , Fibroma/surgery
3.
Cardiovasc Pathol ; 71: 107631, 2024.
Article in English | MEDLINE | ID: mdl-38467167

ABSTRACT

Cardiac papillary fibroelastomas (CPFs) are rare benign cardiac tumors more often involving the left-sided valves and related with threatening embolic complications. We report the case of a 35-year-old woman presenting with relapsing-remitting chest pain and elevated cardiac troponins. After a negative coronary angiography, an integrated imaging assessment based on echocardiography and cardiac magnetic resonance showed a pedunculated mass on the aortic valve causing an intermittent obstructive engagement of the right coronary ostium. A tailored surgical treatment was performed and the histopathological examination of the specimen revealed mesenchymal tissue with the characteristics of CPF.


Subject(s)
Aortic Valve , Cardiac Papillary Fibroelastoma , Heart Neoplasms , Myocardial Infarction , Humans , Female , Adult , Aortic Valve/surgery , Aortic Valve/pathology , Aortic Valve/diagnostic imaging , Heart Neoplasms/pathology , Heart Neoplasms/complications , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging , Cardiac Papillary Fibroelastoma/surgery , Cardiac Papillary Fibroelastoma/pathology , Cardiac Papillary Fibroelastoma/complications , Myocardial Infarction/etiology , Myocardial Infarction/pathology , Treatment Outcome , Coronary Angiography , Coronary Vessels/pathology , Coronary Vessels/diagnostic imaging , Coronary Vessels/surgery , Biopsy , Fibroma/pathology , Fibroma/surgery , Fibroma/complications
4.
J Cardiothorac Surg ; 18(1): 320, 2023 Nov 13.
Article in English | MEDLINE | ID: mdl-37957673

ABSTRACT

BACKGROUND: Cardiac papillary fibroelastomas are rare, accounting for approximately 10% of all cardiac tumors, with 44% of cases located on the aortic valve and only 15% of cases located on the tricuspid valve. However, the optimal management of papillary fibroelastomas remains varied. CASE PRESENTATION: We present two successful instances of treating heart valve papillary fibroelastomas through minimally invasive surgery. These cases involved heart valve papillary fibroelastomas located in two common sites: the aortic valve on the left heart, which was accessed via an upper hemi-sternotomy, and the tricuspid valve on the right heart, which was accessed via beating heart total thoracoscopy. CONCLUSION: The article consistently demonstrates the effectiveness of a minimally invasive surgical approach in managing heart valve papillary fibroelastomas. This study provides further evidence by presenting two cases of heart valve papillary fibroelastomas - one on the aortic valve and the other on the tricuspid valve - that were successfully treated using this approach, resulting in favorable outcomes.


Subject(s)
Cardiac Papillary Fibroelastoma , Fibroma , Heart Neoplasms , Humans , Cardiac Papillary Fibroelastoma/pathology , Aortic Valve/surgery , Aortic Valve/pathology , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/surgery , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/surgery , Minimally Invasive Surgical Procedures , Fibroma/diagnostic imaging , Fibroma/surgery
5.
J Cardiothorac Surg ; 18(1): 316, 2023 Nov 10.
Article in English | MEDLINE | ID: mdl-37950280

ABSTRACT

BACKGROUND: It is very common for patients with newly diagnosed lung masses to have heart disease. However, papillary fibroelastomas (PFEs) of the tricuspid valve (TV) combined with lung cancer are rarely reported. It is thus unclear whether a two-stage surgery or concomitant surgery is optimal. CASE PRESENTATION: We report the case of a 73-year-old Chinese male who was diagnosed with PFEs on the TV by transthoracic echocardiography (TTE) examination while being evaluated to undergo video-assisted thoracic surgery (VATS) for a right lower lung nodule. We resected both the PFEs and the lung nodule via right minithoracotomy. The surgery was uneventful, and histopathology reports confirmed PFEs of the TV and moderately to poorly differentiated squamous cell carcinoma. The patient recovered uneventfully, and there was no sign of tumor recurrence during 15 months of follow-up. CONCLUSIONS: We suggest that after careful evaluation, concomitant minimally invasive radical resection of primary lung cancer after cardiac PFE removal is an acceptable and safe treatment strategy and should be performed as soon as possible.


Subject(s)
Cardiac Papillary Fibroelastoma , Fibroma , Heart Neoplasms , Lung Neoplasms , Male , Humans , Aged , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/surgery , Cardiac Papillary Fibroelastoma/pathology , Lung Neoplasms/surgery , Lung Neoplasms/pathology , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/surgery , Neoplasm Recurrence, Local/pathology , Minimally Invasive Surgical Procedures , Lung/pathology , Fibroma/diagnostic imaging , Fibroma/surgery
6.
Kyobu Geka ; 76(5): 404-407, 2023 May.
Article in Japanese | MEDLINE | ID: mdl-37150924

ABSTRACT

A 72-year-old female had persistent severe chest pain while climbing stairs. She was diagnosed as having acute coronary syndrome, and underwent an emergency coronary angiography (CAG). The right coronary artery (RCA) ostium was sub-totally occluded. Echocardiography revealed a 10 mm mobile mass at the right coronary cusp of the aortic valve. To avoid total obustruction on two drug eluting stents were placed at the RCA ostium so as to have the proximal end protrude into the right Valsalva sinus. Thus, her hemodynamic condition was stabilized. The tumor was surgically resected and the stents were easily removed. Pathologically, the tumor was papillary fibroelastoma. Postoperative aortic regurgitation was minimal echocardiography, and CAG showed normal RCA.


Subject(s)
Acute Coronary Syndrome , Aortic Valve Insufficiency , Cardiac Papillary Fibroelastoma , Fibroma , Humans , Female , Aged , Acute Coronary Syndrome/diagnostic imaging , Acute Coronary Syndrome/etiology , Acute Coronary Syndrome/surgery , Cardiac Papillary Fibroelastoma/pathology , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Coronary Angiography , Fibroma/complications , Fibroma/diagnostic imaging , Fibroma/surgery
7.
Monaldi Arch Chest Dis ; 94(1)2023 May 24.
Article in English | MEDLINE | ID: mdl-37222428

ABSTRACT

An otherwise healthy 32-year-old woman suffered from finger ischemia. An echocardiogram and computed tomography scan revealed a mobile mass in the left ventricle that was attached to the anterior papillary muscle and did not involve the valve leaflets. The tumor was resected, and histopathology confirmed it to be a papillary fibroelastoma. Our case emphasizes the significance of a comprehensive diagnostic work-up for a peripheral ischemic lesion. This resulted in the discovery of an unusual intra-ventricular origin for a commonly benign tumor.


Subject(s)
Cardiac Papillary Fibroelastoma , Fibroma , Heart Neoplasms , Female , Humans , Adult , Cardiac Papillary Fibroelastoma/pathology , Heart Neoplasms/diagnosis , Heart Neoplasms/diagnostic imaging , Fibroma/diagnosis , Fibroma/diagnostic imaging , Papillary Muscles/diagnostic imaging , Papillary Muscles/pathology , Heart Ventricles/diagnostic imaging , Heart Ventricles/pathology
8.
Acta Chir Belg ; 123(5): 563-565, 2023 Oct.
Article in English | MEDLINE | ID: mdl-35395925

ABSTRACT

BACKGROUND AND AIM: Papillary fibroelastoma (PFE) represents only 16% of the benign cardiac tumor and approximately 15% of these are located on the tricuspid valve. MATERIALS AND METHODS: Over a period of 22 years (1999-2021) we observed 75 pts with cardiac tumors at our Center over 9650 pts operated on but only one case of a tricuspid valve PFE in a 69-year-old patient. Trans-thoracic echocardiography demonstrated a mobile mass (20 × 10 mm), adhering to the atrial side of the septal leaflet of the tricuspid valve of unknown origin. In consideration of the mobility of the mass and the consequent high embolic risk, surgical removal was made. The patient underwent surgery through a median sternotomy on CPBP. A 'gelatinous' mass adhering to the tricuspid leaflet was found and completely removed. The postoperative course was uneventful. The pathological diagnosis was PFE. CONCLUSIONS: PFEs of the tricuspid valve are rare entities being in most cases found incidentally. In our experience, the incidence of this tumor in this location is 1/10,000 cases of cardiac surgery. Although most patients are asymptomatic, surgical treatment is nevertheless recommended in consideration of the high embolic risk.


Subject(s)
Cardiac Papillary Fibroelastoma , Fibroma , Heart Neoplasms , Humans , Aged , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/surgery , Tricuspid Valve/pathology , Cardiac Papillary Fibroelastoma/pathology , Fibroma/diagnostic imaging , Fibroma/surgery , Echocardiography , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/surgery
9.
J Cardiothorac Surg ; 16(1): 151, 2021 May 29.
Article in English | MEDLINE | ID: mdl-34051789

ABSTRACT

BACKGROUND: Papillary fibroelastomas are rare but benign cardiac tumour that are often found on cardiac valvular surfaces. Their clinical manifestations ranging from clinically asymptomatic to substantial complications that are usually secondary to systemic embolism. Multiple theories have been proposed to explain the pathophysiology of its formation. CASE PRESENTATION: We reported a rare case of large papillary fibroelastoma in the right atrium of a young gentleman which was complicated with pulmonary embolism. Transthoracic echocardiography identified a large pedunculated mass measuring 3.4cmX3.4cmX2cm in right atrium with stalk attached to interatrial septum. The intracardiac mass was resected surgically, which revealed papillary fibroelastoma in histology examination. CONCLUSION: Differential diagnosis of intracardiac masses requires clinical information, laboratory tests and imaging modalities including echocardiography. Incidentally discovered papillary fibroelastomas are treated on the basis of their sizes, site, mobility and potential embolic complications. Due to the embolic risk inherent to intraacardiac masses, surgical resection represents an effective curative protocol in treating both symptomatic and asymptomatic right sided and left sided papillary fibroelastomas, with excellent long term postoperative prognosis.


Subject(s)
Cardiac Papillary Fibroelastoma/diagnosis , Dyspnea/etiology , Pulmonary Embolism/etiology , Adult , Cardiac Papillary Fibroelastoma/complications , Cardiac Papillary Fibroelastoma/pathology , Cardiac Papillary Fibroelastoma/surgery , Catheters, Indwelling , Central Venous Catheters , Diabetic Nephropathies/complications , Diagnosis, Differential , Echocardiography , Heart Atria/diagnostic imaging , Heart Atria/pathology , Humans , Male , Renal Dialysis
11.
Ann R Coll Surg Engl ; 103(1): 53-58, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32969255

ABSTRACT

INTRODUCTION: Primary benign right ventricular tumours are rare. They can cause significant mortality without appropriate and timely treatment. We investigated surgical treatment and survival characteristics for right ventricular tumours. MATERIALS AND METHODS: From 2007 to 2017, 21 patients with primary benign right ventricular tumours who underwent tumour resection were retrospectively reviewed. Clinical findings and follow-up results were analysed. RESULTS: Thirteen men and eight women were enrolled, with a mean age of 42.3 ± 15.3 years. The most frequent histotypes were myxoma, haemangioma and papillary fibroelastoma. Eight patients underwent concomitant tricuspid valvuloplasty and one had tricuspid valve replacement. No major adverse events or death occurred during the perioperative period. One patient with haemangioma underwent partial tumour resection; however, the tumour regressed gradually during follow-up. Within the 10-year follow-up period (mean 4.8 ± 2.6 years), the recurrence-free and overall survival rates were 81.0% and 85.7%, respectively. CONCLUSIONS: Tumour resection for primary benign right ventricular tumours is safe and effective, and has a good prognosis. Tricuspid valvuloplasty or tricuspid valve replacement may be necessary for the resection of right ventricular tumours to improve the haemodynamics. Haemangiomas naturally undergo spontaneous regression.


Subject(s)
Cardiac Papillary Fibroelastoma/surgery , Cardiac Surgical Procedures/methods , Heart Neoplasms/surgery , Hemangioma/surgery , Myxoma/surgery , Neoplasm Recurrence, Local/epidemiology , Adult , Asymptomatic Diseases/mortality , Asymptomatic Diseases/therapy , Cardiac Papillary Fibroelastoma/mortality , Cardiac Papillary Fibroelastoma/pathology , Disease-Free Survival , Female , Follow-Up Studies , Heart Neoplasms/mortality , Heart Neoplasms/pathology , Heart Ventricles/pathology , Hemangioma/mortality , Hemangioma/pathology , Humans , Male , Middle Aged , Myxoma/mortality , Myxoma/pathology , Neoplasm Recurrence, Local/prevention & control , Remission, Spontaneous , Retrospective Studies
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