A Case of Latent Multiple Papillary Fibroelastomas on the Aortic Valve
- VernacularTitle:大動脈弁に術中確認された潜在的多発乳頭状弾性線維腫の1例
- Author:
Kay MAEDA
1
;
Tomoyuki SUZUKI
1
;
Konosuke SASAKI
1
;
Shuhei TANAKA
2
;
Tomohiro ITO
2
;
Tomoko TOMIOKA
2
;
Kiichiro KUMAGAI
1
;
Yoshikatsu SAIKI
1
Author Information
- Keywords: multiple papillary fibroelastomas; cardiac tumor; echocardiography; aortic valve replacement
- From:Japanese Journal of Cardiovascular Surgery 2023;52(5):310-313
- CountryJapan
- Language:Japanese
- Abstract: A 70-year-old female with a pulmonary embolism was admitted to a local hospital. On admission, transthoracic echocardiography detected a mobile cardiac tumor on the aortic valve. After medical treatment for a pulmonary embolism, she was slated for a resection of the tumor in our hospital. Although preoperative examinations showed an isolated tumor attached to the non-coronary cusp without valve dysfunction, meticulous intraoperative inspection revealed multiple fine villous tumors located in the left coronary cusp of the aortic valve. Being immersed in saline solution, these tumors had resembled a distinctive sea anemone-like appearance. These fine tumors could not be detected with intraoperative transesophageal echocardiography even in a retrospective manner. We eventually performed aortic valve replacement. The tumors of the two cusps were pathologically diagnosed as papillary fibroelastoma. Of note, a macroscopically undetected tumor was identified in the right coronary cusp by histopathological evaluation. Careful intraoperative observation is essential for surgical decision and patient’s prognosis. It is also considered that latent tumor might be concealed even in seemingly normal adjacent cusps in a case with multiple papillary fibroelastomas.
