Multiple papillary fibroelastoma in left ventricle associated with obstructive hypertrophic cardiomyopathy

A 68-year-old man was referred to our hospital with a left ventricular (LV) mass and obstructive hypertrophic cardiomyopathy (HOCM). Although he was treated for the LV thrombosis and received anticoagulation therapy, the mass did not decrease in size for three years. His past history was colon cancer which was resected in its early phase. Laboratory studies revealed the absence of any inflammatory and tumor marker symptoms. Transthoracic and transesophageal echocardiography revealed a mass of 24x11 mm in diameter attached to the septal wall of LV and another two or three masses detected in LV wall. He received surgical treatment with complete mass excision with LV dissection and hypertrophied ventricular muscle was resected. Surgical resection of these LV masses and septal myectomy was performed. The histological examination showed that the lesions had a papillary configuration with an avascular connective tissue core lined by a single layer of endothelial cells, which was sufficient for a diagnosis of cardiac papillary fibroelastoma (CPF). The patient recovered without any complications.