AI Article Synopsis
- Benign cardiac tumors are rare, with cardiac myxoma being the most common; however, left intraventricular presentations are unusual and require consideration of other tumors like papillary fibroelastoma.
- A 73-year-old woman had a cardiac mass identified via echocardiography after experiencing a transient ischemic attack, showing characteristics in cardiac magnetic resonance imaging that suggested a papillary fibroelastoma despite initial indications of a cardiac myxoma.
- The case illustrates that cardiac magnetic resonance (CMR) can effectively differentiate between papillary fibroelastoma and cardiac myxoma, especially when the mass size and mobility allow for detailed tissue characterization.
Article Abstract
Background: Benign cardiac tumours are infrequent in clinical practice and, of these, cardiac myxoma is the one with the highest incidence. Given that a left intraventricular presentation is rare, other differential diagnoses such as papillary fibroelastoma should be considered.
Case Summary: A 73-year-old woman patient with cardiac mass detected in transthoracic echocardiography (TTE) after a transient ischaemic attack. At TTE 2D-3D, a left intraventricular mass anchored at the level of the anterolateral papillary muscle was detected. Subsequently, cardiac magnetic resonance (CMR) was performed for mass characterization. This revealed behaviour in T1 (isointense with respect to myocardium), T2 (hyperintense), very prolonged T1-mapping (1848 msg), and T2-mapping (161 msg) values, without gadolinium uptake in the first-pass perfusion sequence, but with intense uptake in late enhancement sequences. Previous findings were compatible with a diagnosis of papillary fibroelastoma. The mass was resected intraoperatively and, although its macroscopic appearance pointed to a diagnosis of cardiac myxoma, it was finally confirmed to be a papillary fibroelastoma by pathological anatomy.
Discussion: In cases where the size of the mass and its mobility allow tissue characterization by CMR, a diagnosis of papillary fibroelastoma and its differentiation with cardiac myxoma are feasible by this cardiac imaging technique.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9351726 | PMC |
| http://dx.doi.org/10.1093/ehjcr/ytac315 | DOI Listing |
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