Iranian Heart Journal

Iranian Heart Journal

Mitral Valve Papillary Fibroelastoma as an Incidental Finding in a 62-Year-Old Man: A Case Report

Document Type : Case Report

Authors
Azin Alizadeasl 1
Mahnaz Farajollahi 2
Seyedeh Fatemeh Hosseini Jebelli 1
Masoud Sayad 1
Sohiela Salari 2
Shahla Meshgi 3
Mahshid Hesami 4
1 Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
2 Department of Cardiology, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
3 Department of Cardiac Imaging, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
4 Department of Pathology, Rajaie Cardiovascular Medical and Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
Abstract
Background: Primary cardiac tumors are rare, with the majority being benign. Papillary fibroelastoma (PFE) represents the third most common type of primary benign cardiac tumor. While most patients with PFEs remain asymptomatic, the condition is incidentally discovered in approximately one-third of cases. Nonetheless, some patients initially present with embolic events, such as stroke, transient ischemic attack, myocardial infarction, or symptoms of cardiac obstruction, including syncope, heart failure, or even death due to coronary ostial obstruction. Although PFEs are benign, they can pose life-threatening risks if they lead to valve obstruction or systemic embolization.
 
Case Presentation: A 62-year-old man was evaluated for exertional dyspnea (functional class II) and found to have a large, well-defined, round, hypermobile echo-dense mass attached to the ventricular side of the anterior mitral valve leaflet. Pathological examination confirmed the diagnosis of PFE.
 
Conclusions: Given that PFEs are relatively common tumors, they should be included in the differential diagnosis of cardiac masses. Despite their benign nature, urgent surgical resection is not only lifesaving but also critical in preventing tumor-related vascular, embolic, or neurological complications. (Iranian Heart Journal 2025; 26(2): 88-96)
Keywords
Primary cardiac tumors
Papillary fibroelastoma
Cardiac mass
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Iranian Heart Journal
Volume 26, Issue 2
Spring 2025
Pages 88-96