[Right ventricular fibroma. Value of different methods of invasive and noninvasive exploration]

The authors report the case of a 20 year old man with a primary cardiac tumour. The relative usefulness of invasive (catheterisation and angiography), and non-invasive investigations (echocardiography, computerised axial tomography, myocardial scintigraphy and digitalised angiography) in determining operability and the benign or malignant nature of the tumour was evaluated. The patient was admitted to hospital for severe incapacitating effort dyspnoea. Cardiac auscultation was suggestive of pulmonary stenosis associated with tricuspid regurgitation. M mode and 2D echocardiography demonstrated a large mass within the right ventricular cavity and also its size shape, mobility and its relationship to the interventricular septum, tricuspid valve and the main pulmonary artery. Echo contrast studies confirmed tricuspid regurgitation and also demonstrated a patent foramen ovale. The cardiac CAT scan confirmed the preceding data. Myocardial scintigraphy demonstrated the vascular character of the tumour. Digitalised angiography showed the presence of a tumour in the right ventricle and the rest of the morphological information was identical to that obtained by conventional angiography. Cardiac catheterisation demonstrated an obstruction to right ventricular ejection and abnormal filling of both ventricles. It was the association of 2D echocardiography and Technetium 99 myocardial scintigraphy which provided the most information. The results of the other investigations were not essential in deciding the operative indications. A 230 g tumour was excised at surgery and the tricuspid valve replaced by a Hancock n 33 bioprosthesis. Anatomopathological examination showed the tumour to be a fibroma. The finding of a tricuspid diastolic rumble led to control catheter and angiographic studies 13 days after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)