Multidetector computed tomography findings of a papillary fibroelastoma of the aortic valve: a case report

Abstract

Papillary fibroelastoma is a rare benign cardiac tumor that represents 10% of all primary cardiac tumors. Diagnosis is accomplished incidentally by echocardiography that is usually performed for another purpose. Most papillary fibroelastomas are asymptomatic, but the lesions are recognized as a cause of embolisms. To the best of our knowledge, there has been no case report of computed tomography findings of a papillary fibroelastoma. We report a case of a papillary fibroelastoma in a 78-yr-old woman who had dyspnea and chest tightness. Echocardiography revealed a small lobulated mobile echogenic mass attached to the aortic valve, and CT demonstrated a lobulated soft tissue density mass with a thin stalk at the sinotubular junction of the aortic valve.

Keywords: Aortic Valve; Echocardiography; Heart Neoplasms; Multidetector CT.

Fig. 1

Transesophageal echocardiography shows a 15×10 mm sized lobulated echogenic mass attached to the sinotubular junction of the aortic valve.

Fig. 2

Axial (A) and coronal (B) CT images show an 11 mm lobulated soft tissue density mass (arrow) at the sinotubular junction between the right coronary cusp (R) and noncoronary cusp (N) of the aortic valve. A volume-rendered image (C) shows a thin stalk (arrow) that is connected between the lesion and the aortic valve. A virtual aortoscopic image (D) shows a lobulated mass (arrow).

Fig. 3

A gross specimen demonstrates the fibroelastoma appearing as an approximate 11 mm sized lesion with multiple threads on the surface and some gelatinous materials in part of the mass.

Fig. 4

A photomicrograph shows that the papillary fronds consist of dense connective tissue core surrounded by flat endothelial cells (H&E; original magnification,×10).