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Journal of Cardiothoracic Surgery

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Open Access 01-12-2021 | Cardiac Tumor | Case report

Case report: surgical resection of right ventricular cardiac fibroma in an adult patient

Authors: Hirohisa Ikegami, Anthony Lemaire, Subhashini Gowda, Billie Fyfe, Mahmoud Ali, Mark J. Russo, Leonard Y. Lee

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

Cardiac fibromas are rare benign cardiac neoplasms, most frequently occurring in the pediatric population; with very rare cases identified in adults. The tumors are comprised of spindled cells with myofibroblastic ultrastructural features embedded in generally collagenous and elastic stroma. The tumors are intramural in the ventricles, most commonly the left ventricle. Clinical symptoms vary by location and size of tumor and some are asymptomatic. Surgical resection is curative, but rare cases require cardiac transplantation.

Case presentation

We report an asymptomatic, large, right ventricular fibroma in a 64-year-old woman. The patient underwent open incisional tumor biopsy via lower hemi-sternotomy, followed by complete tumor resection via full sternotomy a week later after confirming the tumor is benign. The tumor was resected using cardiopulmonary bypass, and the defect of right ventricular free wall was repaired using a prosthetic double-patch technique. The postoperative course was uneventful. The patient was discharged to home on day 4 post-complete tumor resection.

Conclusion

This report expands the existing literature for better comprehension and detection of cardiac fibroma patients and also highlights the various imaging modalities, surgical management, and histological analysis.

Torimitsu S, Nemoto T, Wakayama M, Okubo Y, Yokose T, Kitahara K, et al. Literature survey on epidemiology and pathology of cardiac fibroma. Eur J Med Res. 2012;17(1):5. https://doi.org/10.1186/2047-783X-17-5.CrossRefPubMedPubMedCentral

Padalino MA, Vida VL, Boccuzzo G, Tonello M, Sarris GE, Berggren H, et al. Surgery for primary cardiac tumors in children: early and late results in a multicenter European Congenital Heart Surgeons Association study. Circulation. 2012;126(1):22–30. https://doi.org/10.1161/CIRCULATIONAHA.111.037226.CrossRefPubMed

Cho SH, Fritz T, Cronin LJ, Cohle SD. Primary cardiac fibroma in an adult. Case Rep Cardiol. 2015;2015:713702.PubMedPubMedCentral

Chen Y, Sun J, Chen W, Peng Y, An Q. Third-degree atrioventricular block in an adult with a giant cardiac fibroma. Circulation. 2013;127:e522–44.PubMed

Cho JM, Danielson GK, Puga FJ, Dearani JA, McGregor CG, Tazelaar HD, et al. Surgical resection of ventricular cardiac fibromas: early and late results. Ann Thorac Surg. 2003;6:1929–34.CrossRef

Jha NK, Kiraly L, Tamas C, Talo H, Khan MD, Badaoui HE, et al. Large cardiac fibroma and teratoma in children- case reports. J Cardiothorac Surg. 2015;10:38.CrossRef

Elderkin RA, Radford DJ. Primary cardiac tumours in a paediatric population. J Paediatr Child Health. 2002;38(2):173–7. https://doi.org/10.1046/j.1440-1754.2002.00734.x.CrossRefPubMed

Fussen S, De Boeck BW, Zellweger MJ, Bremerich J, Goetschalckx K, Zuber M, et al. Cardiovascular magnetic resonance imaging for diagnosis and clinical management of suspected cardiac masses and tumours. Eur Heart J. 2011;32(12):1551–60. https://doi.org/10.1093/eurheartj/ehr104.CrossRefPubMed

Beghetti M, Gow RM, Haney I, Mawson J, Williams WG, Freedom RM. Pediatric primary benign cardiac tumors: a 15-year review. Am Heart J. 1997;134(6):1107–14. https://doi.org/10.1016/s0002-8703(97)70032-2.CrossRefPubMed

10.

Becker AE. Primary heart tumors in the pediatric age group: a review of salient pathologic features relevant for clinicians. Pediatr Cardiol. 2000;21(4):317–23. https://doi.org/10.1007/s002460010071.CrossRefPubMed

11.

Kusajima K, Hata H, Fujita T, Shimahara Y, Sato S, Ishibashi-Ueda H, et al. Successful surgical treatment for recurrent cardiac fibroma 21 years after resection. Surg Case Rep. 2015;1(1):41. https://doi.org/10.1186/s40792-015-0043-3.CrossRefPubMedPubMedCentral

12.

Michler RE, Goldstein DJ. Treatment of cardiac tumors by orthotopic cardiac transplantation. Semin Oncol. 1997;24(5):534–9.PubMed

13.

Abu Saleh WK, Ramlawi B, Shapira OM, Jabbari OA, Ravi V, Benjamin R, et al. Improved outcomes with the evolution of a neoadjuvant chemotherapy approach to right heart sarcoma. Ann Thorac Surg. 2017;104(1):90–6. https://doi.org/10.1016/j.athoracsur.2016.10.054.CrossRefPubMed

Title: Case report: surgical resection of right ventricular cardiac fibroma in an adult patient
Authors: Hirohisa Ikegami
Anthony Lemaire
Subhashini Gowda
Billie Fyfe
Mahmoud Ali
Mark J. Russo
Leonard Y. Lee
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Cardiac Tumor
Sternotomy
Cardiac Tumor
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01514-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Case report: surgical resection of right ventricular cardiac fibroma in an adult patient

Abstract

Background

Case presentation

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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