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Review
. 2020 Aug 26;13(8):e235361.
doi: 10.1136/bcr-2020-235361.

Cardiac papillary fibroelastoma originating from the coumadin ridge and review of literature

Hassan Mehmood Lak  1 , Connor Charles Kerndt  2 , Shinya Unai  3 , Anjli Maroo  4
Affiliations
Review

Cardiac papillary fibroelastoma originating from the coumadin ridge and review of literature

Hassan Mehmood Lak et al. BMJ Case Rep. .

Abstract

Papillary fibroelastomas represent the second most common benign cardiac tumour, secondary only to cardiac myxoma. A majority of patients are asymptomatic on presentation. The most common clinical manifestations include stroke, transient ischaemic attack, myocardial infarction and angina. Echocardiography remains the primary imaging modality for identification of these tumours. The majority of papillary fibroelastomas arise from the valves. Simple surgical excision is the mainstay of treatment, carrying an excellent prognosis. We present an unusual case of cardiac papillary fibroelastoma originating from the coumadin ridge (CR) in a 70-year-old woman. The patient exhibited increasing paroxysms of her atrial fibrillation and was pursuing a MAZE procedure. Preoperatively, a transesophageal echocardiogram revealed a 0.7×1 cm intracardiac mass that had echocardiographic appearance of a fibroelastoma. Surgical resection and MAZE procedures were performed. The gross specimen and histopathology findings were consistent with papillary fibroelastoma. This case reports the seventh documented case of fibroelastoma originating from the CR.

Keywords: cancer - see oncology; cardiothoracic surgery; interventional cardiology; surgical oncology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Transthoracic echocardiography with mid oesophageal view showing mobile mass attached to the coumadin ridge (white arrow).
Figure 2
Figure 2
TEE showing CPF attached to the CR. CPF, cardiac papillary fibroelastoma; CR, coumadin ridge; LAA, left atrial appendage; LUPV, left upper pulmonary vein; TEE, transesophageal echocardiogram.
Figure 3
Figure 3
Gross appearance of the left atrial mass after surgical resection.
Figure 4
Figure 4
Intraoperative view of small cardiac papillary fibroelastoma attached to the coumadin ridge.
See this image and copyright information in PMC

References

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