Papillary fibroelastoma with an atypical location
Abstract
A 61-year-old woman was referred to our hospital for assessment of a cardiac mass depicted by transthoracic echocardiography (TTE). She had a medical history of stroke 10 years prior to admission and reported new-onset fatigue, with no other cardiovascular symptoms.
Full text
Re
Po
Ca diol.
2019;38(10):739---740
www. e po ca diol.o g
Re is a
Po uguesa
de
Ca diologia
Po uguese
Jou nal
o
Ca diology
IMAGE
IN
CARDIOLOGY
Papilla y
fib oelas oma
wi h
an
a ypical
loca ion
Fib oelas oma
papila
com
localizac¸ão
a ípica
Joana
Riguei aa,∗,
Rui
Plácidoa,
A u
Cos a
e
Sil ab,
Ana
G.
Almeidaa,
Faus o
J.
Pin oa
aSe ic¸o
de
Ca diologia,
Hospi al
Uni e si á io
de
San a
Ma ia
(CHULN),
CAML,
CCUL,
Faculdade
de
Medicina
da
Uni e sidade
de
Lisboa,
Po ugal
bSe ic¸o
de
Ana omia
Pa ológica,
Hospi al
de
San a
Ma ia
(CHULN),
Po ugal
Recei ed
7
Decembe
2018;
accep ed
13
Janua y
2019
A ailable
online
3
Janua y
2020
A
61-yea -old
woman
was
e e ed
o
ou
hospi al
o
assessmen
o
a
ca diac
mass
depic ed
by
ans ho acic
echoca diog aphy
(TTE).
She
had
a
medical
his o y
o
s oke
10
yea s
p io
o
admission
and
epo ed
new-onse
a igue,
wi h
no
o he
ca dio ascula
symp oms.
Figu e
1
(A-C)
Sho -axis,
apical
4-
and
2-chambe
ans ho acic
echoca diog aphic
images,
espec i ely,
showing
a
ound
mass
inside
he
le
en icle,
a ached
o
he
papilla y
muscle
(a ow);
(D)
h ee-dimensional
echoca diog aphic
sho -axis
iew
using
he
2-Click
C op
unc ion
om
he
apex;
(E
and
F)
his opa hology;
(E)
neo o m
o
papilla y
a chi ec u e
(Masson’s
ich ome,
25×);
(F)
papilla y
axes
consis ing
o
collagen,
s ained
g een,
and
lax
s oma
wi h
endo helial/endoca dial
coa ing
(Masson’s
ich ome,
100×).
∗Co esponding
au ho .
E-mail
add ess:
[email p o ec ed]
(J.
Riguei a).
TTE
e ealed
a
highly
mobile
ound
1.4
cm×1.4
cm
isoechogenic
mass
a
he
mid
le
en icula
(LV)
le el
wi h
no
ob ious
inse ion
base
(Figu e
1A-C).
LV
ejec ion
ac ion
was
no mal
and
he
al es
had
no
pa hological
changes.
Fo
be e
cha ac e iza ion
o
he
ana omy
and
mass
we
h ps://doi.o g/10.1016/j. epc.2019.01.007
0870-2551/©
2019
Sociedade
Po uguesa
de
Ca diologia.
Published
by
Else ie
Espa˜
na,
S.L.U.
This
is
an
open
access
a icle
unde
he
CC
BY-NC-ND
license
(h p://c ea i ecommons.o g/licenses/by-nc-nd/4.0/).
740
J.
Riguei a
e
al.
pe o med
h ee-dimensional
echoca diog aphy
(Figu e
1D)
which
showed
he
mass
a ached
o
he
base
o
he
an e o-
la e al
papilla y
muscle.
The
myoca dium
unde lying
he
mass
appea ed
no mal,
wi h
no
signs
o
infil a ion.
Gi en
he
high
p edic ed
embolic
isk,
he
pa ien
unde wen
su gical
excision
o
he
mass.
The
pa hological
diagnosis
was
papilla y
fib oelas oma
(Figu e
1E
and
F).
The
pa ien ’s
pos ope a i e
cou se
was
une en ul
and
wo
mon hs
a e
su ge y
she
was
asymp oma ic
wi h
no
esidual
mass
on
echoca diog aphic
eassessmen .
Papilla y
fib oelas oma
is
a
a e
benign
umo
ha
accoun s
o
ewe
han
10%
o
p ima y
ca diac
umo s.
These
umo s
can
a ise
anywhe e
in
he
hea ,
bu
usu-
ally
in ol e
he
su ace
o
he
ao ic
and
mi al
al es,
and
a ely
he
a ia
o
en icles.
We
desc ibed
a
a e
case
o
a
papilla y
fib oelas oma
o igina ing
om
he
an e o-
la e al
papilla y
muscle.
Su gical
esec ion
is
gene ally
cu a i e.
Conflic s
o
in e es
The
au ho s
ha e
no
conflic s
o
in e es
o
decla e.