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Papillary fibroelastoma located deep in the left ventricle: case study and literature review
Maria Isabel Sá1, Hipólito Reis, Vítor Lagarto
1Servico de Cardiologia, Hospital Geral de Santo António, Porto, Portugal. isabelpsa@portugalmail.pt
Insights
A rare cardiac tumor, papillary fibroelastoma, caused a stroke in a 68-year-old man. Complete surgical removal via transaortotomy was successful, preventing recurrence.
Area of Science:
- Cardiology
- Cardiac Surgery
- Oncology
Background:
- Papillary fibroelastomas are rare, benign cardiac tumors.
- These tumors can cause embolic events, leading to stroke or other systemic complications.
- Left ventricular tumors are uncommon, with specific location influencing presentation and management.
Observation:
- A 68-year-old male with no prior cardiac history presented with a cerebral embolic event.
- The event was attributed to a papillary fibroelastoma located in the inferior left ventricular wall.
- Echocardiography confirmed the tumor's presence and characteristics.
Findings:
- The tumor's location in the mid-inferior left ventricle was highly unusual.
- Clinical and echocardiographic findings were consistent with previously described fibroelastomas.
- Transaortotomy provided optimal visualization for complete tumor resection.
Implications:
- Complete surgical excision is crucial for favorable outcomes and preventing tumor recurrence.
- Individualized surgical approaches are necessary for managing cardiac tumors.
- This case highlights the importance of considering cardiac tumors in embolic stroke evaluations.
Abstract:
The authors report a case of a 68-year-old male, with no known cardiac disease until he suffered a cerebral embolic event related to the presence of a papillary fibroelastoma located in the mid third of the inferior left ventricular wall. They also perform a literature review, particularly of the specific characteristics of the tumor and the surgical approach. They point out that the location of the fibroelastoma described is very unusual; its clinical and echocardiographic characteristics are similar to those described for fibroelastomas with this location and the surgical approach should be decided for each individual patient. Thus transaortotomy, which provided better visualization and enabled complete removal of the tumor (which is essential for good clinical evolution and to avoid recurrence), was the option for surgical removal of this tumor.
