Multiple papillary fibroelastoma: report of a case and implications for management

A 59-year-old woman with chest discomfort was transferred to our hospital. Echocardiography was suggestive of multiple papillary fibroelastoma (PFE). Tumors on both the left and right coronary cusps were confirmed macroscopically and pathologically and a small tumor was noted microscopically on the non-coronary cusp. Aortic valve replacement was successfully performed. The treatment and recurrence rate of PFE is controversial due to its rarity. Given that multiple tumors were seen in the present case and that possible recurrence has been reported elsewhere, valve replacement may be a better choice for surgical repair than valvoplasty in some cases, such as a single PFE in which plasty may be difficult or multiple PFEs regardless of impaired valve function.