Papillary fibroelastomas are rare benign primary cardiac tumors. However, of the primary cardiac tumors, they are one of the commonest to occur in relation to the cardiac valves (may account for 75% of valvular tumors 10).
Its estimated prevalence ranges between < 0.01 to 0.33 % 5. There may be slightly increased male predilection 10.
Characterized by papillary growth of stromal tissue composed of a centraldense amorphous fibrous core and an surrounding layer of loose connectivetissue. There is a also a layer of elastic fibers (hallmark) which is variable in distribution. This is further surrounded by a single layerof hypertrophied endothelium.
~ 80% occur in relation to either the aortic of mitral valve 2 while tricuspid and pulmonary involvement is much rarer.
Typically seen as a small ( ~1.5 cm 5) well defined pedunculated mass in relation to a valve.
- T1 - intermediate intensity 1-2
- T2 - inter mediate to high intensity 1-2
- SSFP Cine - may be useful for showing mobility (often highly mobile)
- systemic embolization of tumor or thrombotic components 5
Surgical resection is the treatment of choice.