Unusual presentation of papillary fibroelastoma: utility of serial transesophageal echocardiograms.
Papillary fibroelastomas are uncommon benign tumors usually involving heart valves that may be potential sources of emboli. Transesophageal echocardiography has greatly enhanced the ability to make the diagnosis of these surgically treatable tumors in a timely fashion. We describe an unusual presentation of a 62-year-old man with suspected bacterial endocarditis, in whom initial transesophageal echocardiogram suggested the presence of pacemaker lead infection but a repeat study after extraction of the pacemaker lead revealed a large pedunculated mass arising from the superior vena cava. The mass was surgically removed and histopathology revealed papillary fibroelastoma. This case is unusual with respect to the size and site of origin of the papillary fibroelastoma as well as its echocardiographic presentation mimicking vegetations on a pacemaker wire.
Vora
Tushar R
TR
Department of Cardiology, Cardiothoracic Division, State University of New York at Buffalo, Buffalo, NY, USA. trvora@buffalo.edu
D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004567:Electrodes, Implanted / Q000382:microbiology; D004698:Endocarditis, Subacute Bacterial / Q000175:diagnosis*; D005350:Fibroma / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006338:Heart Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis*