Korean J Thorac Cardiovasc Surg.  2016 Jun;49(3):195-198. 10.5090/kjtcs.2016.49.3.195.

Tricuspid Papillary Fibroelastoma Mimicking Tricuspid Vegetation in a Patient with Severe Neutropenia

• Choi KB
• Kim HW
• Kim DY
• Jo KH
• Choi HJ
• Hong SB

• KMID: 2285809
• DOI: http://doi.org/10.5090/kjtcs.2016.49.3.195

Abstract

We report a 72-year-old male with known myelodysplastic syndrome who presented to the emergency department with a 7-day history of fever and dyspnea. Echocardiography revealed a round echogenic mass 13×16 mm in size attached to the atrial side of the tricuspid valve. Considering the high risk of infective endocarditis in the patient with a low absolute neutrophil count (130/mm3), emergency surgery was performed. Intraoperatively, a single gelatinous neoplasm was resected, and subsequent reconstruction of the involved leaflet was accomplished using autologous pericardium. The tumor was pathologically confirmed as papillary fibroelastoma with no evidence of infective endocarditis. Papillary fibroelastoma is a rare cardiac neoplasm that occurs in either the mitral or aortic valves. Interestingly, a few cases of tricuspid valve papillary fibroelastoma have been reported so far. Similar echocardiographic findings between vegetation and tricuspid valve neoplasm make it difficult to distinguish these two disease entities.

Keyword

Heart neoplasms; Fibroelastoma; Tricuspid valve

MeSH Terms

Aged
Aortic Valve
Dyspnea
Echocardiography
Emergencies
Emergency Service, Hospital
Endocarditis
Fever
Gelatin
Heart Neoplasms
Humans
Male
Myelodysplastic Syndromes
Neutropenia*
Neutrophils
Pericardium
Tricuspid Valve
Gelatin