A case of papillary fibroelastoma in the left ventricle
A 65-year-old woman was referred to our cardiology department for evaluation of a cardiac mass of the left ventricle. Prior to the referral, she was admitted to another hospital with a complaint of chest pain of 3 days' duration. Coronary angiography and echocardiography were performed before she visited our hospital. Coronary angiography showed no significant coronary disease, but a mass was found by echocardiography. She had been treated for hypertension and a stroke she suffered 5 years prior.\nOn physical examination, her blood pressure was 110/70 mmHg, and her pulse rate was 62 beats/min. Her heart sounds were normal and no murmur was heard. The electrocardiogram showed normal sinus rhythm without abnormal findings. Transthoracic echocardiography revealed a 1.8 × 1.7 cm highly mobile round mass attached by a stalk on the apical inferior wall of the left ventricle with an echolucent area (). The mass was easily compressed () and returned to its original shape () by the motion of the left ventricle during the cardiac cycle. CT of the chest showed a 1.9 × 1.6 cm round and pedunculated mass with soft tissue density on the apical inferior wall of the left ventricle (). The patient was referred to the Department of Thoracic Surgery. On opening the left atrium, there was a mass attached deep to the inferior wall of the left ventricle. Both the mass and stalk were resected. The resected tumor was 1.8 × 1.5 cm and had the appearance of a sea anemone ().\nIntraoperative transesophageal echocardiography demonstrated the absence of a residual mass. Histology showed that the lesion had a papillary configuration with an avascular connective tissue core (). The postoperative course was uneventful.