Primary pulmonary valve papillary fibroelastoma.

Area of Science:

• Cardiology
• Oncology
• Pathology

Background:

• Papillary fibroelastoma (PFE) is a rare, benign cardiac tumor originating from the valvular endocardium.
• PFEs are often discovered incidentally during echocardiography or cardiac surgery.
• While histologically benign, PFEs pose a risk of significant embolic complications.

Observation:

• A 73-year-old male patient with a history of hepatocellular carcinoma presented with an incidentally detected 2.5-cm mass in the pulmonary trunk.
• The mass was located superior to the pulmonary valve, specifically on the commissure of the right and posterior pulmonary cusp.
• Echocardiography confirmed the presence and location of the cardiac tumor.

Findings:

• Surgical excision of the pulmonary trunk mass was performed via a transpulmonary arterial approach with cardiopulmonary bypass.
• Histopathological examination confirmed the diagnosis of papillary fibroelastoma.
• The tumor was successfully removed along with the involved endocardium.

Implications:

• Papillary fibroelastomas, despite their benign nature, can lead to life-threatening embolic events, including stroke, myocardial infarction, and pulmonary embolism.
• Prompt identification and surgical resection of cardiac tumors like PFE are critical for preventing potentially fatal embolic complications.
• This case highlights the importance of vigilant cardiac surveillance, particularly in patients with a history of malignancy or other risk factors.