Published in:
01-03-2020 | Case image in cardiovascular ultrasound
Atypical localization of a papillary fibroelastoma in the ligament of Marshall
Published in: Journal of Echocardiography | Issue 1/2020
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We report a 71-year-old female patient with an atypical location of a papillary fibroelastoma (PFE). She has a history of stroke without sequelae 18 months before admission and was derived to our Hospital for tumor resection. Based on brain CT scan findings, we confirmed a diagnosis of cerebral infarction. TEE showed a mobile mass, ovoid, 20 × 14 mm, in the left atrium, adhered to the ligament of Marshall, with an irregular surface compatible with a PFE (Fig. 1a and Movie 1). In our previous study, PFEs [1] were located in heart valves in 70.54% of cases and in 29.6%, they were located in the endocardium of the heart. In our patient, PFE were located in the ligament of Marshall, which to our knowledge has never been reported previously in the echocardiographic literature.
Fig. 1
a Transesophageal echocardiography. LA left atrium, LV left ventricle, LAA left atrial appendage, LUPV left upper pulmonary vein. White arrow = PFE. b–e Gross and microscopic appearance of the excised PFE. b Out of the water, the tumor reveals a smooth surface. c Optic microscopy: PFE with its papillae shown in transverse section. d Optic microscopy: PFE with stroma with a pink of elastic fiber is seen. e Optic microscopy: PFE with fibrin between the papillae is also seen
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