Korean Circ J.  2013 Sep;43(9):636-639. 10.4070/kcj.2013.43.9.636.

Primary Cardiac Angiofibroma

• Kim YJ
• Kim YJ
• Kim SH
• Youn YN
• Park S

• KMID: 2224821
• DOI: http://doi.org/10.4070/kcj.2013.43.9.636

Abstract

Cardiac Angiofibroma is an uncommon intracardiac tumor. Thus far, only 4 cases of the rare intracardiac tumor have been reported. The present case-report describes an intracardiac angiofibroma in a 57-year-old healthy female. The patient was incidentally diagnosed with a left ventricle mass during echocardiography. We performed cardiac imaging, surgical excision and histological evaluation of the mass. The angiofibroma demonstrated features different from the relatively common cardiac tumors such as fibroma, myxoma and angiosarcoma. The cardiac MRI showed slightly high signal intensity on both T1 and T2, with the central core of lower signal intensity. The resected tumor was a whitish and rubbery mass. Histologically, the tumor showed the benign vascular proliferations associated with the surrounding collagen deposition.

Keyword

Cardiac tumor; Magnetic resonance imaging

MeSH Terms

Angiofibroma
Collagen
Echocardiography
Female
Fibroma
Heart Neoplasms
Heart Ventricles
Hemangiosarcoma
Humans
Magnetic Resonance Imaging
Middle Aged
Myxoma
Collagen

Figure

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  Fig. 1 A: T1 weighted image shows high signal intensity (arrow). B: T2 weighted image shows high signal intensity (arrow). C: delayed enhancement (phase-sensitive inversion recovery MR image) shows stong enhancement with central sparing (arrow). D: transthoracic echocardiographic images: four chamber view shown. It shows round shaped and echogenic mass attached at the left ventricular apex (arrow).

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  Fig. 2 Gd-DTPA first pass perfusion MRI in short axis view. The lesion shows centripetal enhancement pattern (clockwise from top left).

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  Fig. 3 On gross examination, a whitish, solid mass is detached from the base of the anterolateral papillary muscle.

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  Fig. 4 A: on lower power view, the mass is somewhat well demarcated. And the mass seems to be originated from myocardium (arrows) (H-E, ×12). B: high power view shows multiple irregular vascular spaces (arrows) with intervening wavy eosinophilic collagen deposition (H-E, ×100). The vascular spaces express CD31 immunoreactivity (CD31 ×400 inlet). C: desmin immunohistochemical staining reveals that most of stroma do not express desmin except smooth muscles around vessel (arrows) (Desmin ×100). D: most of the stroma shows bluish staining on trichrome (trichrome ×100). Desmin and trichrome staining confirms that most of stroma consists of collagen, not smooth muscle.

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