Casavecchia Grazia, Gravina Matteo, Zicchino Stefano, Moranti Enrico, Cuculo Andrea, Macarini Luca, Di Biase Matteo, Brunetti Natale Daniele
Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Fondazione Giovanni Paolo Ii, Campobasso, Italy.
J Cardiovasc Echogr. 2018 Oct-Dec;28(4):236-238. doi: 10.4103/jcecho.jcecho_48_18.
Papillary fibroelastoma is a rare benign cardiac tumor, second after cardiac myxoma as more frequent cardiac valvular tumor. The therapy is usually based on surgery according to size, mobility, symptoms, and risks of surgery. We report the case of a 67-year old female with transient ischemic attack. Echocardiography showed the presence of a round mobile formation localized on the atrial side of septal leaflets of tricuspid valve, first identified as an endocarditis vegetation. Cardiac magnetic resonance (cMRI) confirmed the presence of the mass and showed an isointense signal in T1-turbo spin echo sequences, hypointense in cine steady-state free precession and in first-pass sequences, and hyperintense in T2 and phase-sensitive inversion recovery with central hypointense core, with a suspected diagnosis of fibroelastoma. The patient underwent cardiac surgery and histology confirmed the presence of fibroelastic tissue with papillary extroflexions compatible with diagnosis of fibroelastoma. The use of cMRI may be useful in the evaluation of the exact position, dimensions, and nature of cardiac masses and fibroelastomas, diagnostic workup, and preliminary assessment before surgery.
乳头状纤维弹性瘤是一种罕见的心脏良性肿瘤，是仅次于心脏黏液瘤的较常见的心脏瓣膜肿瘤。治疗通常根据肿瘤大小、活动度、症状及手术风险采取手术治疗。我们报告一例67岁女性短暂性脑缺血发作患者。超声心动图显示在三尖瓣隔叶心房侧有一个圆形可移动结构，最初被诊断为感染性心内膜炎赘生物。心脏磁共振成像（cMRI）证实了肿块的存在，在T1加权快速自旋回波序列中呈等信号，在电影稳态自由进动序列和首过序列中呈低信号，在T2加权和相位敏感反转恢复序列中呈高信号，中心有低信号核心，疑似诊断为纤维弹性瘤。患者接受了心脏手术，组织学检查证实存在伴有乳头状外突的纤维弹性组织，符合纤维弹性瘤的诊断。cMRI在评估心脏肿块和纤维弹性瘤的准确位置、大小和性质、诊断检查以及手术前的初步评估中可能有用。
