Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation.
OBJECTIVE
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 x 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.
Klarich
K W
KW
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. klarich.kyle@mayo.edu
Enriquez-Sarano
M
M
Gura
G M
GM
Edwards
W D
WD
Tajik
A J
AJ
Seward
J B
JB
D004699:Endocardium / Q000473:pathology; D005260:Female; D005350:Fibroma / Q000000981:diagnostic imaging* / Q000473:pathology; D006338:Heart Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000473:pathology; D006351:Heart Valves / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography