Symptomatic papillary tumour of the pulmonary valve.

Papillary ‘tumours’ are small pedunculated lesions of the valve cusps and result from wear-and-tear. They are therefore frequent post-mortem findings in older patients. The vast majority are clinically silent, though occasionally such lesions when on the aortic valve may produce symptoms of myocardial or cerebral ischaemia. None has been known to cause symptoms when in the right side of the heart. A 52-year-old woman is reported who had transient episodes of right ventricular outflow obstruction related to the presence of a papillary tumour on the pulmonary valve. Extensive radiotherapy to the chest wall was thought to be a causal factor.