title: Environmental pollution as a cause of papillary fibroelastoma: hints for a new etiological hypothesis?
abstract: BACKGROUND
  Environmental pollution has adverse human health effects, mostly on the respiratory tract but also on the cardiovascular system. Papillary fibroelastomas are exceedingly rare primary cardiac tumors; their pathologic origin remains still elusive.
  
  
  METHODS
  This is a brief report on 3 patients referred for surgical treatment of papillary fibroelastomas in the last 6 months. All patients were born, lived, and worked in a narrow region in Campania that is under active monitoring because of high rates of environmental pollution.
  
  
  CONCLUSIONS
  Known mechanisms of cardiovascular damage generated by environmental pollution are cross linked with described papillary fibroelastomas' etiological cascade. Evidence is suggested for a common origin. These results provide intriguing but inconclusive insights into pathophysiological pathways that may link exposure to environmental pollution and development of papillary fibroelastomas.
authors.affiliation: Department of CardioThoracic Sciences, Second University of Naples, Naples, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: De Feo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Dialetto
authors.forename: Veronica
authors.initials: V
authors.lastname: D'Oria
authors.forename: Paolo
authors.initials: P
authors.lastname: Pepino
authors.forename: Salvatore
authors.initials: S
authors.lastname: Giordano
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cotrufo
authors.forename: Luca Salvatore
authors.initials: LS
authors.lastname: De Santo
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods; D003937:Diagnosis, Differential; D018450:Disease Progression; D017548:Echocardiography, Transesophageal; D004787:Environmental Pollution / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D005350:Fibroma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005500:Follow-Up Studies; D006338:Heart Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged