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| __NOTOC__
| | #REDIRECT [[Cardiac tumors]] |
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| Image = Papillary fibroelastoma 001.jpg|
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| Caption = Papillary Fibroelastoma: When located on the mitral valve, these tumors are usually on the anterior leaflet of the atrial surface.|
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| ==Overview==
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| A '''papillary fibroelastoma''' is a [[primary tumors of the heart|primary tumor of the heart]] that typically involves one of the valves of the [[heart]]. Papillary fibroelastomas, while considered generally rare, make up about 10 percent of all primary tumors of the heart.<ref name="Palecek-2008">{{cite journal | author=Palecek T, Lindner J, Vitkova I, Linhart A. | title=Papillary Fibroelastoma Arising from the Left Ventricular Apex Associated with Nonspecific Systemic Symptoms. | journal=Echocardiography | year=2008 | id=PMID 18177380}}</ref> They are the third most common type of primary tumor of the heart,<ref name="Matsumoto-2007">{{cite journal | author=Matsumoto N, Sato Y, Kusama J, Matsuo S, Kinukawa N, Kunimasa T, Ichiyama I, Takahashi H, Kimura S, Orime Y, Saito S. | title=Multiple papillary fibroelastomas of the aortic valve: case report. | journal=Int J Cardiol | year=2007 | volume=122 | issue=1 | pages=e1-3 | id=PMID 17196273}}</ref> behind [[myxoma|cardiac myxomas]] and cardiac fibromas.
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| ==Symptoms==
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| A papillary fibroelastoma is generally considered benign, however can be associated with [[syncope]]<ref name="Maestroni-2006">{{cite journal | author=Maestroni A, Zecca B, Triggiani M | title=Cardiac papillary fibroelastoma presenting with acute coronary syndrome and syncope. | journal=Acta Cardiol | year=2006 | volume=61 | issue=3 | pages=363-5 | id=PMID 16869462}}</ref>, [[angina|chest pain]], [[myocardial infarction|heart attack]], [[stroke]]<ref name="Liebeskind-2001">{{cite journal | author=Liebeskind DS, Buljubasic N, Saver JL. | title=Cardioembolic stroke due to papillary fibroelastoma. | journal=J Stroke Cerebrovasc Dis | year=2001 | volume=10 | issue=2 | pages=94-5 | id=PMID 17903807}}</ref> and [[sudden cardiac death]].
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| Symptoms due to papillary fibroelastomas are generally due to either mechanical effects of the tumor or due to embolization of a portion of the tumor to a distal organ. In particular, chest pain or syncope may be due to transient occlusion of the [[left coronary artery|left main coronary artery]] by the tumor, while a heart attack or sudden cardiac death may be due to embolization of a portion of the tumor into a coronary artery.<ref name="Takada-2000">{{cite journal | author=Takada A, Saito K, Ro A, Tokudome S, Murai T. | title= Papillary fibroelastoma of the aortic valve: a sudden death case of coronary embolism with myocardial infarction.| journal=Forensic Sci Int | year=2000 | volume=113 | issue=1-3 | pages=209-14 | id=PMID 10978627}}</ref>
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| ==Treatment==
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| If the tumor is found incidentally in an asymptomatic person, the treatment approach is controversial. Certainly a conservative approach is warranted in certain individuals.<ref name="Mutlu-2008">{{cite journal | author=Mutlu H, Demir IE, Leppo J, Levy WK. | title=Nonsurgical Management of a Left Ventricular Pedunculated Papillary Fibroelastoma: A Case Report. | journal=J Am Soc Echocardiogr | year=2008 | id=PMID 18191538}}</ref> If the tumor is large and pedunculated, a case may be made for surgical excision prior to symptoms developing due to the higher risk of embolism. However, this is still considered controversial.<ref name="Boodhwani-2007">{{cite journal | author=Boodhwani M, Veinot JP, Hendry PJ. | title=Surgical approach to cardiac papillary fibroelastomas. | journal=Can J Cardiol | year=2007 | volume=23 | issue=4 | pages=301-2 | id=PMID 17380224}}</ref>
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| ===Surgery===
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| If the papillary fibroelastoma is associated with symptoms, surgical excision is generally recommended for relief of symptoms.<ref name="Mutlu-2008" /> A minimally invasive approach may be possible if the tumor involves the [[aortic valve]]<ref name="Hsu-2006">{{cite journal | author=Hsu VM, Atluri P, Keane MG, Woo YJ. | title=Minimally invasive aortic valve papillary fibroelastoma resection. | journal=Interact Cardiovasc Thorac Surg | year=2006 | volume=5 | issue=6 | pages=779-81 | id=PMID 17670711}}</ref> or right atrium.<ref name="Kim-2007">{{cite journal | author=Kim RW, Jeffery ME, Smith MJ, Wilensky RL, Woo EY, Woo YJ. | title=Minimally invasive resection of papillary fibroelastoma in a high-risk patient. | journal=J Cardiovasc Med (Hagerstown) | year=2007 | volume=8 | issue=8 | pages=639-41 | id=PMID 17667039}}</ref> In the case of aortic valve involvement, excision of the tumor is often valve-sparing, meaning that replacement of the valve with a [[aortic valve replacement|prosthetic valve]] is not necessary. Repair of the native valve with a pericardial patch has been described.<ref name="Westhof-2007">{{cite journal | author=Westhof FB, Chryssagis K, Liangos A, Batz G, Diegeler A. | title=Aortic valve leaflet reconstruction after excision of a papillary fibroelastoma using autologous pericardium. | journal=Thorac Cardiovasc Surg | year=2007 | volume=55 | issue=3 | pages=204-7 | id=PMID 17410513}}</ref>
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| ==References==
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| {{reflist|2}}
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| [[Category:Disease]]
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| [[Category:Cardiology]]
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| [[Category:Oncology]]
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| [[Category:Oncology stub]]
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| {{WH}}
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| {{WikiDoc Sources}}
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