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Pseudopapillary fibroelastoma of the mitral valve
1Department of Medicine, Medical College of Ohio, Toledo.
Abstract:
Papillary fibroelastomas are well-recognized benign cardiac neoplasms. They are primarily asymptomatic, but occasionally are associated with neurologic and cardiac symptoms. Pseudopapillary fibroelastomas presenting with usual clinical and echocardiographic manifestations of papillary fibroelastoma but lacking characteristic histologic features have not been described previously. This article describes a 42-year-old, previously healthy female admitted with sudden hemiparesis and dysarthria. Symptoms completely resolved within 4 days. Extensive investigations revealed no etiology except for a pedunculated mitral valve mass with echocardiographic appearance suggestive of papillary fibroelastoma. Histologic staining, however, failed to reveal characteristic features of papillary fibroelastoma.
Insights
This case report details a rare pseudopapillary fibroelastoma, a benign cardiac tumor, presenting with stroke-like symptoms. Despite typical imaging, histology differed, highlighting diagnostic challenges for cardiac neoplasms.
Area of Science:
- Cardiovascular Pathology
- Neoplastic Disease
- Neurological Manifestations
Background:
- Papillary fibroelastomas are common benign cardiac tumors, typically asymptomatic but can cause embolic events.
- Neurologic symptoms like hemiparesis and dysarthria are known complications of cardiac tumors.
Observation:
- A 42-year-old female presented with acute hemiparesis and dysarthria, which resolved spontaneously.
- Echocardiography revealed a pedunculated mass on the mitral valve, mimicking papillary fibroelastoma.
Findings:
- Histological examination of the mitral valve mass did not show the characteristic features of a papillary fibroelastoma.
- This represents a potential new variant or a challenging diagnostic case of cardiac neoplasms.
Implications:
- The findings suggest that echocardiographic findings suggestive of papillary fibroelastoma may not always correlate with typical histology.
- This case underscores the importance of considering atypical presentations and the limitations of histology in diagnosing cardiac tumors.
- Further research into pseudopapillary fibroelastomas is warranted to refine diagnostic criteria and understand their behavior.