Ten Tumors in the Heart: Papillary Fibroelastoma With Triple Valve Involvement

Cardiac papillary fibroelastoma (CPF) is a benign tumor of endocardial origin, most frequently solitary, which commonly affects the aortic valve. We report the case of a 62-year-old woman with 10 separate tumors that developed on the mitral, tricuspid, and pulmonary cusps; atrioventricular valve chordae; and left ventricular endocardium. Surgical treatment included valve-sparing resection of the pulmonary cusp tumors and bioprosthetic replacement of the mitral and tricuspid valves, which exhibited extensive tumor invasion. The postoperative course was unremarkable. The high number of CPFs and triple-valve tumor involvement are both exceptional. CPF should be considered whenever multiple cardiac masses are discovered.