Papillary Fibroelastoma: Echocardiographic Characteristics for Diagnosis and Pathologic Correlation

• Published in: Journal of the American College of Cardiology Vol. 30; no. 3; pp. 784 - 790
• Main Authors: Klarich, Kyle W., Enriquez-Sarano, Maurice, Gura, George M., Edwards, William D., Tajik, A.Jamil, Seward, James B.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.1997; Elsevier Science
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Endocardium - pathology; Female; Fibroma - diagnostic imaging; Fibroma - pathology; Heart; Heart Neoplasms - diagnostic imaging; Heart Neoplasms - pathology; Heart Septum - diagnostic imaging; Heart Septum - pathology; Heart Valves - diagnostic imaging; Heart Valves - pathology; Humans; Male; Medical sciences; Middle Aged; Retrospective Studies; Tumors of the heart; Ultrasonography; TTE; TEE; TIA; PFE; CAD; CVA; Sonography; Heart; Human; Pathology; Optical microscopy; Echocardiography; Elastofibroma; Heart disease; Clinical form; Cardiovascular disease; Benign neoplasm; Diagnosis
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(97)00211-8

Objectives. We sought to determine the clinical and echocardiographic characteristics of papillary fibroelastoma (PFE). Background. PFE is a rarely encountered cardiac tumor about which relatively little is known. Methods. Institutional records were reviewed for the years 1980 to 1995 for patients with pathologic or echocardiographic diagnosis of PFE. Group 1 included 17 patients with the pathologic diagnosis of PFE who also underwent echocardiography. Echocardiographic features of PFE were established in group 1. Group 2 included 37 patients with only echocardiographic evidence of PFE. Results. In group 1, 7 (41.2%) of 17 patients had symptoms related to PFE. Neurologic events occurred in 5 (29.4%) of 17 patients. All patients had the tumor surgically removed. During follow-up, no new embolic events occurred. Echocardiographic characteristics of PFE included a small tumor (12.1 ± 6.5 × 9.0 ± 4.3 mm), usually pedunculated (14 [94%] of 17 patients) and mobile, with a homogeneous speckled pattern and a characteristic stippling along the edges. PFEs were most common on valvular surfaces (12 [60%] of 20 PFEs) but were not uncommon on other endocardial surfaces (8 [40%] of 20 PFEs). The tumor did not cause valvular dysfunction. In group 2, 16 (43%) of 37 patients were asymptomatic. Five patients (13.5%) had a previous neurologic event. During follow-up (mean 31 months, range 1 to 77), nine neurologic events occurred. Conclusions. PFEs are associated with embolism, can be diagnosed with echocardiography, are often an incidental clinical finding and do not cause valvular dysfunction.