Multimodality cardiac imaging of a left ventricular papillary fibroelastoma: a case report
Rajat Sharma1, Mehrdad Golian1, Pallav Shah2
1Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, Rm Y3531, Bergen Cardiac Care Centre, St. Boniface Hospital, University of Manitoba, 409 Tache Avenue, Winnipeg, Manitoba, Canada, R2H 2A6.
Background:
In the setting of an acute myocardial infarction (AMI), although the most common etiology of a left ventricular (LV) mass identified on multimodality cardiovascular imaging is a thrombus, other possibilities including a vegetation or tumor should be entertained within the differential diagnosis.
Case Presentation:
We describe a case of a 43-year-old Caucasian female post AMI diagnosed with a mid-cavitary mass within the LV. Although echocardiography and cardiovascular MRI (CMR) suggested that the mass was a thrombus, given the context of the recent AMI, exploration and surgical excision was completed by the surgeon due to the potential for the mass to embolize.
Conclusion:
The final diagnosis of a papillary fibroelastoma was unique due to its unusual location and large size within the LV cavity. This unique case demonstrates shortcomings of multimodality cardiac imaging in the diagnosis of an atypical mass and the importance of obtaining tissue when clinically safe and feasible.
