scholarly journals ECHOGENIC MASS ATTACHED TO TRICUSPID VALVE

2021 ◽  
Vol 54 (2) ◽  
pp. 201-202
Author(s):  
Imran Hameed
Keyword(s):  
Tricuspid Valve ◽  
Adult Congenital Heart Disease ◽  
Female Child ◽  
Papillary Fibroelastoma ◽  
Right Atrial ◽  
Cardiac Tumors ◽  
Primary Tumors ◽  
Secondary Tumors ◽  
Echo Features ◽  
Intracardiac Masses

SUMMARY A 5-day old female child with complaints of tachypnea, had TTE which revealed an echogenic mass on septal leaflet of Tricuspid valve. Based on echocardiographic features, it was diagnosed as Papillary fibroelastoma. CASE DESCRIPTION A 5-day old female child was referred for transthoracic echocardiographic study due to respiratory difficulty. The child was afebrile and had a respiratory rate of 60/min, heart rate 130 bpm, and blood pressure 80/50 mmHg. No murmur or added sound heard on CVS examination. TTE revealed a dense mass (Figure 1) attached to right atrial side of septal leaflet of Tricuspid valve by a small pedicle. The mass was mobile, prolapsing into right ventricle during diastole (Clips) without causing obstruction with size of 0.8 X 0.74 cm. Intracardiac masses attached to valves are usually Papillary fibroelastomas. Other possible differential diagnoses could be myxoma, vegetation, Lambl’s excrescence or secondary tumors etc. Based on the location and echo features of the mass (mobility, attachment to downstream side of valve, and frond like speckled appearance) the diagnosis of Papillary fibroelastoma was made.  LEARNING POINTS Cardiac tumors are rare and mostly benign. The three most common primary tumors of heart, in order of frequency, are myxomas, lipomas and papillary fibroelastomas respectively. PFE constitute 7% - 9% of all.1 PFE usually arise from valves of the heart and are mostly left-sided.2 They are mobile, range from 0.5 – 2 cm in size and have a frond-like appearance. On echo, they are dense with a speckled interior and shimmering surface.3 Being prone to embolization and thrombosis, their clinical course may not be benign, especially left sided. Clips Subcostal Clip: https://youtu.be/_xTZmx--WcA PS SAX View: https://youtu.be/lLh6D9Vn4Fw A4C View: https://youtu.be/_xZZvTIh0S8 A4C RV Directed View: https://youtu.be/vJRyHrevftA QUESTIONS WITH ANSWERS Question 1: What is the most common complication of papillary fibroelastoma? Question 2: The behavior of right and left sided papillary fibroelastomas could be markedly different, Y/N? Question 3: What is the most important feature of papillary fibroelastoma for embolization? Question 4: PFE preferentially affects females, Y/N?  Answers Question 1: Cerebral embolism Question 2: Yes Question 3: Mobility Question 4: No References Bouhzam N, Kurtz B, Doguet F, Eltchaninoff H, Bauer F. Incidental papillary fibroelastoma multimodal: imaging and surgical decisions in 2 patients. Tex Heart Inst J. 2012;39(5):731-5. Eidem BW, Cetta F, O’ Leary PW. Echocardiography in pediatric and adult congenital heart disease. Lippincott, Williams and Wilkins, Wolters Kluwer. 2010 p 355-361. Klarich KW, Enriquez-Sarano M, Gura GM, Edwards WD, Tajik AJ, Seward JB. Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation. J Am Coll Cardiol. 1997;30(3):784-90.

scholarly journals P729 A shocking tumor

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Lorente Ros ◽  
M Pascual Izco ◽  
R Hinojar-Baydes ◽  
A Carvelli ◽  
J M Vieitez Florez ◽  
...  
Keyword(s):  
Late Gadolinium Enhancement ◽  
Tricuspid Valve ◽  
Cardiac Mri ◽  
Cardiac Ct ◽  
Central Core ◽  
Papillary Fibroelastoma ◽  
Right Atrial ◽  
Cardiac Tumors ◽  
Gadolinium Enhancement ◽  
Modality Approach

Abstract Introduction Primary cardiac tumors are a relatively uncommon condition, which may appear both in asymptomatic patients or in a myriad of clinical presentations. Imaging techniques are crucial for its diagnosis, and a multi-modality approach may be useful in the evaluation of this masses. Case description A 57 year-old man with history of hypertension presented in the emergency department with acute pulmonary edema and cardiogenic shock. He was admitted to the coronary care unit, and on bedside echocardiography a mass on the tricuspid valve was observed. Upon clinical improvement, a cardiac CT and cardiac MRI was performed (figure 1). A solid mass with no calcium content and dependent exclusively on the anterior leaflet of the tricuspid valve was seen on CT-scan (fig 1, A and B). Thrombus on the right atrial appendage could also be appreciated. MRI confirmed the presence of a 18x19 mm mass with isointense signal on T1-turbo spin echo black-blood (fig 1, C) and cine steady-state free precession sequences, whereas an hyperintense signal was evident on T2 weighted images (T2-STIR; fig 1 D). In first pass sequences the central core was hypointense and late gadolinium enhancement showed peripheral enhancement with a non captating central core (fig 1, E). The patient underwent surgery and the anatomopathological results showed a tumor constituted by dense connective tissue, scarce cellular content and an avascular matrix of mucopolysaccharides, elastic fibers and fusiform cells consistent with the diagnosis of papillary fibroelastoma. Discussion The imaging characteristics of papillary fibroelastoma are not commonly reported on MRI. We present an unusually large right-sided fibroelastoma with a characteristic distribution of late gadolinium enhancement, which has not been consistently described on a fibroelastoma. Cardiac tumors are rare, and a non-invasive differential diagnosis is always a challenge. A multi-modality approach (echocardiography, cardiac-CT and cardiac MRI) as well as integration of relevant morphological information, including the location of the lesion and tissue characteristics was essential to the orientate the most plausible diagnosis. The distinctive images are presented. Abstract P729 Figure 1.

scholarly journals Papillary fibroelastoma of the aortic valve

2014 ◽  
Vol 71 (6) ◽  
pp. 600-602 ◽  
Author(s):  
Filip Vukmirovic ◽  
Mihailo Vukmirovic ◽  
Irena Tomasevic-Vukmirovic
Keyword(s):  
Aortic Valve ◽  
Benign Tumor ◽  
Clinical Presentation ◽  
Incidental Finding ◽  
Papillary Fibroelastoma ◽  
Cardiac Tumors ◽  
Autopsy Case ◽  
Primary Tumors ◽  
Echocardiographic Examination ◽  
History Of

Introduction. Primary tumors of the heart are rare, usually benign and occur mostly in adults, and usually originate from the endocardium, followed by the myocardium and rarest of the pericardium. Papillary fibroelastoma accounts for less than 10% of all cardiac tumors, but they are most common valvular tumors. The clinical presentation of papillary fibroelastoma varies from asymptomatic cases to cases which have severe clinical presentation that is most likely due to embolic complications. Tumor can usually be discovered by echocardiography or during autopsy. Case report. We reported a case of 53- year-old man submitted to routine echocardiographic examination. The patient had the history of hypertension for five years, without any other symptoms. Echocardiography found a round tumor attached to the noncoronary cuspis of the aortic valve. The tumor was surgically removed and pathohistological examination confirmed diagnosis of papillary fibroelastoma. After surgery the patient fully recovered without tumor recurrence or aortic regurgitation. Conclusion. Histologically, papilary fibroelastoma is benign tumor of the heart. As demonstrated in this case, a papillary fibroelastoma can be an incidental finding discovered during echocardiography in patients with the history of hypertension.

scholarly journals Cardiac Tumors

ISRN Oncology ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Ioannis A. Paraskevaidis ◽  
Christos A. Michalakeas ◽  
Constantinos H. Papadopoulos ◽  
Maria Anastasiou-Nana
Keyword(s):  
Histological Examination ◽  
Diagnostic Tool ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Diagnostic Information ◽  
Cardiac Tumors ◽  
Primary Tumors ◽  
Secondary Tumors ◽  
3D Echo ◽  
Primary Cardiac Tumors

Cardiac tumors represent a relatively rare, yet challenging diagnosis. Secondary tumors are far more frequent than primary tumors of the heart. The majority of primary cardiac tumors is benign in origin, with primary malignant tumors accounting for 25% of cases. Metastatic tumors usually arise from lung, breast, renal cancer, melanomas, and lymphomas. Clinical manifestations of cardiac tumors depend on the size and location of the mass and the infiltration of adjacent tissues rather than the type of the tumor itself. Echocardiography is the main diagnostic tool for the detection of a cardiac mass. Other imaging modalities (C-MRI, C-CT, 3D Echo) may offer further diagnostic information and the establishment of the diagnosis is made with histological examination. Management depends on the type of the tumor and the symptomatology of the patient.

scholarly journals A Rare Case of Papillary Fibroelastoma Involving The Tricuspid Valve. A single Center experience over a period of 22 years (1999-2021)

2021 ◽  
Author(s):  
Claudia Calia ◽  
Vittoria Lodo ◽  
Guglielmo Actis Dato ◽  
Gianfranco Cappuccio ◽  
Enrico Italiano ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Rare Case ◽  
Median Sternotomy ◽  
Papillary Fibroelastoma ◽  
Surgical Removal ◽  
Cardiac Tumors ◽  
Single Center Experience ◽  
Pathological Evaluation ◽  
Mobile Mass ◽  
Embolic Risk

Background and aim Papillary fibroelastoma (PFE) represents only 16% of the benign cardiac tumor and approximately 15% of these are located on tricuspid valve. Materials and Methods Over a period of 22 years (1999-2021) we observed 75 pts with cardiac tumors at our Center over 9650 pts operated on. Most of them were mixoma but in 10 cases histology showed a PFE. We describe a rare case (1/75 of cardiac tumors) of a tricuspid valve PFE in a 69-year-old patient. Trans-thoracic echocardiography demonstrated a mobile mass (20 x 10 mm), adhering to the atrial side of the septal leaflet of the tricuspid valve. In consideration of the mobility of the mass and the consequent high embolic risk, surgical removal was made. Patient underwent surgery through a median sternotomy on CPBP. A “gelatinous” mass adhering to the tricuspid leaflet was found and completely removed. The postoperative course was uneventful. The pathological evaluation confirmed the diagnosis of PFE. Conclusions PFE of the tricuspid valve is rare entities being in most cases found incidentally. In our experience the incidence of this tumor in this location is 1/10000 cases of cardiac surgery. Although most patients are asymptomatic, surgical treatment is nevertheless recommended in consideration of the high embolic risk.

scholarly journals Cardiac Angiosarcoma:A case report and review of the literature

2021 ◽  
Author(s):  
Limin Luo ◽  
Weipeng Zhao ◽  
Kun Liu
Keyword(s):  
Case Report ◽  
Malignant Tumors ◽  
Right Atrial ◽  
Cardiac Tumors ◽  
Review Of The Literature ◽  
Primary Tumors ◽  
Cardiac Angiosarcoma ◽  
Right Atrial Appendage ◽  
The Right ◽  
Primary Cardiac Tumors

Primary cardiac tumors are extremely rare.Most primary tumors are benign,and malignant tumors comprise about 15%1.Angiosarcoma is the most common type of primary cardiac malignant tumors.Compared with the left atrium or ventricle,the tumor prefer to occur in the right atrium or ventricle,especially the right atrium.In this case report,we present the case of a 32-year-old female with cardiac angiosarcoma primary to the right atrial appendage(RAA).

Heart tumors: classification, clinic, characteristics, radiology signs

2019 ◽  
pp. 24-41
Author(s):  
M. Kadyrova ◽  
Yu. A. Stepanova ◽  
M. G. Grinberg ◽  
E. S. Malyshenko ◽  
V. S. Shirokov ◽  
...  
Keyword(s):  
Early Detection ◽  
Clinical Symptoms ◽  
Malignant Tumors ◽  
Rapid Development ◽  
Diagnostic Methods ◽  
Cardiac Tumors ◽  
Imaging Features ◽  
Primary Tumors ◽  
Secondary Tumors ◽  
Heart Tumors

Primary tumors of the heart are a rare pathology with a frequency of occurrence of 0.0017% to 0.28% according to autopsies, while 75% of them are benign in nature, 25% are malignant. Secondary tumors of the heart occur 20–40 times more often than primary tumors. Due to the rapid development of radiology diagnostic methods, the chances of early detection of heart tumors have improved significantly at present. Recently, large cardiology centers have accumulated a lot of experience in the diagnosis and treatment of these lesions. However, early detection in primary malignant lesions of the heart is still a problem, since the clinical symptoms appear when tumors reach a large size. Modern methods of treatment of the heart malignant tumors include radical surgery, and in case of impossibility – cytoreductive surgery.We present literature review on the diagnostic methods and differential diagnosis of the heart lesions. The types of cardiac tumors are described; its morphological features, differential diagnostic imaging features and hemodynamic characteristics of the lesions are presented; the diagnostic effectiveness of modern imaging methods is analyzed.

A rare cause of left ventricular outflow tract mass in infancy: Cardiac papillary fibroelastoma

2021 ◽  
pp. 021849232199850
Author(s):  
Maruti Haranal ◽  
Zul Febrianti ◽  
Haifa A Latiff ◽  
Sabariah A Rahman ◽  
Sivakumar Sivalingam
Keyword(s):  
Left Ventricular Outflow Tract ◽  
Pediatric Population ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Papillary Fibroelastoma ◽  
Cardiac Tumors ◽  
Left Ventricular Outflow ◽  
Intracardiac Masses ◽  
Primary Cardiac Tumors

Primary cardiac tumors are one of the rare causes of intracardiac masses in pediatric population. Cardiac papillary fibroelastomas are benign cardiac tumors with predilection for valvular endocardium, and the presentation is dictated by the cardiac structure involved and the tumor characteristics. We report an infant with cardiac papillary fibroelastoma manifesting as an asymptomatic left ventricular outflow tract mass. This case is being presented to emphasize the rare occurrence of cardiac papillary fibroelastoma in pediatric population and to be cognizant of this entity when considering differential diagnosis of intracardiac masses in this subgroup.

scholarly journals A Large Left Atrial Myxoma Obstructing the Mitral Valve Orifice

2014 ◽  
Vol 13 (3) ◽  
pp. 87-88
Author(s):  
Md Nazmul Hasan ◽  
Dipal Krishna Adhikary ◽  
Tanjima Parvin
Keyword(s):  
Mitral Valve ◽  
Left Atrial ◽  
Malignant Tumors ◽  
Atrial Myxoma ◽  
Cardiac Tumors ◽  
Primary Tumors ◽  
Left Atrial Myxoma ◽  
Valve Orifice ◽  
Secondary Tumors ◽  
Sporadic Cases

Cardiac tumors represent a relatively rare, yet challenging diagnosis. Secondary tumors are far more frequent than primary tumors of the heart. The majority of primary cardiac tumors are benign in origin, with primary malignant tumors accounting for 25% of cases. Left atrial myxoma is the most common intracardiac tumor. It could be seen in patients between 3–83 years of age, with the majority presenting in fifth decade of life as sporadic cases (90%) and second decade as familial cases (10%)1. It is an important source of central nervous system embolism2. Elderly patients often present with nonspecific symptoms that are often overlooked in the absence of a supporting cardiac history which makes an early diagnosis challenging. This case report discusses an unusual presentation of a large left atrial myxoma in a 35 years old patient which almost completely obstructing the mitral valve orifice during diastole.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.21043

An Unusual Association: Right Atrial Myxoma and Severe Left Ventricular Dysfunction. Case Report and Review of the Literature

2015 ◽  
Vol 17 (6) ◽  
pp. 285
Author(s):  
Lucian Florin Dorobantu ◽  
Ovidiu Chioncel ◽  
Alexandra Pasare ◽  
Dorin Lucian Usurelu ◽  
Ioan Serban Bubenek-Turconi ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Ventricular Dysfunction ◽  
Left Ventricular Systolic Dysfunction ◽  
Left Ventricular ◽  
Right Atrial ◽  
Left Ventricular Ejection ◽  
Cardiac Tumors ◽  
Severe Left Ventricular Dysfunction ◽  
Ventricular Ejection Fraction ◽  
Increased Risk

Myxomas comprise 50% of all benign cardiac tumors in adults, with the right atrium as their second most frequent site of origin. Surgical resection is the only effective therapeutic option for patients with these tumors. The association between right atrial myxomas and severe left ventricular systolic dysfunction is extremely rare and makes treatment even more challenging. This was the case for our patient, a 47-year-old male with a right atrial mass and a severely impaired left ventricular function, with a 20% ejection fraction. Global enlargement of the heart was also noted, with moderate right ventricular dysfunction. The tumor was successfully excised using the on-pump beating heart technique, with an immediate postoperative improvement of the left ventricular ejection fraction to 35%. The technique proved useful, with no increased risk to the patient.

scholarly journals Large papillary fibroelastoma of right atrium, an unusual case of respiratory distress in a young man

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yan Le Ho ◽  
Pui Fong Ng ◽  
Sotheenathan Krishinan ◽  
Basheer Ahamed Abdul Kareem
Keyword(s):  
Right Atrium ◽  
Clinical Manifestations ◽  
Clinical Information ◽  
Interatrial Septum ◽  
Papillary Fibroelastoma ◽  
Case Presentation ◽  
Intracardiac Masses ◽  
The Right ◽  
Embolic Risk

Abstract Background Papillary fibroelastomas are rare but benign cardiac tumour that are often found on cardiac valvular surfaces. Their clinical manifestations ranging from clinically asymptomatic to substantial complications that are usually secondary to systemic embolism. Multiple theories have been proposed to explain the pathophysiology of its formation. Case presentation We reported a rare case of large papillary fibroelastoma in the right atrium of a young gentleman which was complicated with pulmonary embolism. Transthoracic echocardiography identified a large pedunculated mass measuring 3.4cmX3.4cmX2cm in right atrium with stalk attached to interatrial septum. The intracardiac mass was resected surgically, which revealed papillary fibroelastoma in histology examination. Conclusion Differential diagnosis of intracardiac masses requires clinical information, laboratory tests and imaging modalities including echocardiography. Incidentally discovered papillary fibroelastomas are treated on the basis of their sizes, site, mobility and potential embolic complications. Due to the embolic risk inherent to intraacardiac masses, surgical resection represents an effective curative protocol in treating both symptomatic and asymptomatic right sided and left sided papillary fibroelastomas, with excellent long term postoperative prognosis.

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