Papillary fibroelastoma of the right atrium as an unusual source of recurrent pulmonary embolism

Journal of Cardiovascular Medicine
Davide GabbieriItalo Ghidoni

Abstract

Papillary fibroelastoma is the most common primary tumour of cardiac valves, with the potential for embolic events and obstructive effects. Location in non-valvular endocardium is extremely rare. Transthoracic and transoesophageal echocardiography have greatly increased the ability to make the diagnosis of these surgically treatable tumours in a timely fashion. We report the case of a 70-year-old woman with symptoms and ventilation-perfusion scan evidence of pulmonary embolization from a papillary fibroelastoma of the right atrium. Initial transthoracic echocardiography failed to identify the tumour, whereas transoesophageal echocardiography demonstrated a mobile echodense mass attached to the right atrial free wall. After surgical excision, histopathology revealed papillary fibroelastoma. The epidemiology, aetiology, localization, macroscopy, histopathology, immunohistochemistry, clinical presentation, diagnosis and management of cardiac papillary fibroelastoma are reviewed. The case is unusual with respect to the site of origin of the papillary fibroelastoma as well as its clinical presentation, which is clearly related to pulmonary embolization.

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Citations

Sep 21, 2010·Journal of Thrombosis and Thrombolysis·Martina MontagnanaGiuseppe Lippi
Jul 3, 2009·Journal of Cardiothoracic Surgery·Murat BicerAfksendiyos Kalangos
May 13, 2010·Journal of Cardiac Surgery·Jonathan NwilohAda Mercado
Nov 26, 2009·The Annals of Thoracic Surgery·Rubie MayburyGregory Trachiotis
Aug 12, 2008·The Journal of Thoracic and Cardiovascular Surgery·Cipriano Abad, Pilar De la Rosa
Apr 2, 2013·The Journal of Thoracic and Cardiovascular Surgery·Emad Uddin HakemiAsimul Ansari
Jul 29, 2021·Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology·Nana HuGuoqing Du

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