A rare nonvalvular left ventricular papillary fibroelastoma: A case report

Area of Science:

• Cardiology
• Oncology

Background:

• Papillary fibroelastomas are benign cardiac tumors with high embolic potential.
• They are typically found on valvular surfaces, with nonvalvular locations being exceedingly rare.

Purpose of the Study:

• To report a rare case of nonvalvular papillary fibroelastoma.
• To highlight the diagnostic utility of transesophageal echocardiography for nonvalvular cardiac tumors.

Main Methods:

• Case report of a 66-year-old male with basal ganglia infarctions.
• Diagnosis of a left ventricular septal mass using transesophageal echocardiography.
• Cardiac magnetic resonance imaging for tissue characterization.
• Surgical excision and histopathologic examination.

Main Results:

• A rare nonvalvular cardiac papillary fibroelastoma was identified on the left ventricular septum.
• Transesophageal echocardiography accurately characterized the mass based on echogenicity, pedunculated nature, and motion.
• Cardiac MRI confirmed the fibroelastic nature of the tumor.
• Histopathology confirmed the diagnosis of papillary fibroelastoma.

Conclusions:

• Transesophageal echocardiography offers high diagnostic certainty for cardiac papillary fibroelastomas, including those in atypical nonvalvular locations.
• A multimodality imaging approach is not always necessary for diagnosing cardiac papillary fibroelastomas.