PAPILLARY FIBROELASTOMA - ECHOCARDIOGRAPHIC CHARACTERISTICS FOR DIAGNOSIS AND PATHOLOGICAL CORRELATION

Objectives. We sought to determine the clinical and echocardiographic characteristics of papillary fibroelastoma (PFE). Background. PFE is a rarely encountered cardiac tumor about which relatively little is kno wn. Methods. Institutional records were reviewed for the years 1980 to 1995 for patients with pathologic or echocardiographic diagnosis of P FE. Group 1 included 17 patients with the pathologic diagnosis of PFE who also underwent echocardiography. Echocardiographic features of PFE were established in group 1. Group 2 included 37 patients with only e chocardiographic evidence of PFE. Results. in group 1, 7 (41.2%) of 17 patients had symptoms related to PFE. Neurologic events occurred in 5 (29.4%) of 17 patients. All patients had the tumor surgically removed , During follow-up, no new embolic events occurred, Echocardiographic characteristics of PFE included a small tumor (12.1 +/- 6.5 x 9.0 +/- 4.3 mm), usually pedunculated (14 [94%] of 17 patients) and mobile, wi th a homogeneous speckled pattern and a characteristic stippling along the edges. PFEs were most common an valvular surfaces (12 [60%] of 20 PFEs) but were not uncommon an other endocardial surfaces (8 [40%] of 20 PFEs). The tumor did not cause valvular dysfunction. In group 2, 1 6 (43%) of 37 patients were asymptomatic. Five patients (13.5%) had a previous neurologic event. During follow-up (mean 31 months, range I t o 77), nine neurologic events occurred. Conclusions. PFEs are associat ed with embolism, can be diagnosed with echocardiography, are often an incidental clinical finding and do not cause valvular dysfunction. (C ) 1997 by the American College of Cardiology.