Papillary fibroelastoma of the aortic valve: report of a case

This report describes a case of aortic papillary fibroelastoma causing transient ischemic attack (TIA), and is followed by a review of the relevant literature. A tumor measuring 1.5 x 1.5 cm was located in the right coronary cusp of the aortic valve, which was found to have a "sea anemone-like" configuration due to collagenous or elastic papillary projections. Aortic fibroelastoma can cause cerebrovascular symptoms, and this patient presented with TIA. Moreover, aortic fibroelastoma usually causes chest symptoms and occasionally results in death despite its small size of generally less than 1 cm. According to the literature, all of the patients who died of fibroelastoma had an aortic valve tumor in the right or left coronary cusp, which indicates that the location of the tumor rather than its size may be an important factor contributing to the case of death. Surgical treatment is usually indicated especially for aortic fibroelastoma because of the high associated risk or cerebrovascular and chest diseases. The recent evolution of echocardiography will promote the chance of establishing a preoperative diagnosis of this lesion. However, because it is not possible to differentiate fibroelastoma from other lesions, including malignancies, by echocardiography alone, this may be another reason for performing surgical removal.