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Case 3
History
- 59yo male
- Routine executive physical
- C/O: intermittent palpitations
- O/E: nil
- ECG: NSR
- Echocardiogram: difficult exam, ?thickened PV
Findings
- Differential Dx PV Mass: Thrombus
- Vegetation (SBE)
- Tumour: Benign: Papillary Fibroelastoma Lipomas
- Metastasis: Carcinoid Sy
- Calcification (low signal MR)
Diagnosis
- PV Papillary Fibroelastoma
- Benign avascular tumor of the endocardium, often arise from valves.
- Fibrous tissue covered by an elastic membrane, the tumor is covered by the endocardium.
- Usually pedunculated and mobile and rarely cause valvular dysfunction.
- Patients with fibroelastomas are at increased risk for cerebral (AV,MV) or pulmonary (PV,TV) embolism.
Treatment options include:
- surgical removal of the tumor
- anticoagulation with warfarin
- antiplatelet drugs
- or a combination of these approaches