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Papillary fibroelastoma on the mitral valve.

R Toda1, Y Iguro, Y Moriyama

  • 1Second Department of Surgery, Faculty of Medicine, Kagoshima University, Japan.

The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|April 19, 2000
PubMed
Summary

A fragile papillary fibroelastoma, resembling a sea anemone, was found on a patient's mitral valve. Surgical removal was necessary to prevent embolism, despite the patient's age and initial misdiagnosis.

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pathology

Background:

  • A 78-year-old female presented with fever and a history of stroke.
  • Echocardiography revealed mitral valve regurgitation and a mass on the posterior leaflet.
  • Initial diagnosis suggested healed infective endocarditis.

Observation:

  • Intraoperative findings showed an 8mm, sea anemone-like tumor on the mitral posterior leaflet.
  • The tumor was noted to be extremely fragile.
  • The patient underwent tumor removal and mitral valve annuloplasty.

Findings:

  • Pathological examination confirmed the lesion as a papillary fibroelastoma.
  • No evidence of infective endocarditis was found.
  • The etiology of the patient's fever remained undetermined.

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Implications:

  • Papillary fibroelastomas, though rare, are a significant cause of cardiac embolism.
  • Early surgical intervention is crucial for preventing embolic events, even in elderly patients.
  • Accurate preoperative diagnosis and intraoperative handling are vital due to tumor fragility.