Symptomatic Papillary Fibroelastoma- Case Report and Literature Review
Saurabh Joshi *
Department of Medicine, St Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Aditi Ahlawat
University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Alireza Hosseinnezhad
Department of Medicine, St Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Mark Kranis
Division of Cardiology, St Vincent Hospital, Worcester, Massachusetts, USA.
Joshua Greenberg
Division of Cardiology, St Vincent Hospital, Worcester, Massachusetts, USA.
Robert M. Bojar
Division of Cardiothoracic Surgery, St Vincent Hospital, Worcester, Massachusetts, USA.
*Author to whom correspondence should be addressed.
Abstract
Primary cardiac tumors represent a small subset of cardiac neoplasms. The papillary fibroelastoma (PFE) is a benign tumor that typically affects the cardiac valvular system and is second in prevalence only to myxomas. Though typically asymptomatic and diagnosed incidentally, few patients with PFE may also experience neurologic and cardiac symptoms that prompt further diagnostic investigation. We present a case of a patient with transient monocular vision loss with a later occurrence of bilateral lower extremity weakness and confusion over a short period of time. The alarming symptomatology eventually led to diagnosis by transesophageal echocardiogram of a PFE involving the aortic valve. We include a review of the current literature on PFE to further elucidate etiology of this neoplasm, symptomology, prognosis, and treatment. Currently, the role of anticoagulation in PFE remains unclear. Due to the embolic nature of this neoplasm as evidenced by the case presentation, surgical resection, anticoagulation or a combination of both provides patients with maximal prevention of stroke.
Keywords: Papillary fibroelastoma, embolic phenomenon, echocardiography, surgical excision, anticoagulation