A Rare Case of Diffuse Mitral Valve Fibroelastoma

Abstract

Papillary fibroelastomas are uncommon in daily cardiac surgery practice. They typically arise from the valvular endocardium, affecting the atrioventricular and semilunar valves equally [1]. Upon diagnosis, prompt resection should be undertaken because of possible devastating complications such as stroke. A young patient came to the emergency unit with partial left-sided hemiplegia. The patient’s history showed partial loss of sight with spontaneous recovery. Transesophageal echocardiography identified a solitary structure attached to the mitral valve suggestive of fibroelastoma (Fig 1). Intraoperatively, we were confronted with diffusely spread fibroelastomas on the anterior leaflet of the mitral valve (Fig 2), leaving no other option than to replace the valve. Histologic examination confirmed the diagnosis of fibroelastoma (Fig 3; hematoxylin and eosin staining). The patient’s postoperative recovery was uneventful. She was discharged on the eighth postoperative day. Cardiac fibroelastomas are rare tumors, typically involving the heart valves. The preferred therapy is to perform repair of the valve whenever possible. If the tumor has a diffuse character, this is not an acceptable option, and replacement of the valve should be performed.