Abstract
BackgroundCardiac 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 presentationWe 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.ConclusionThis 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.
Highlights
BackgroundCardiac fibroma is a rare benign primary tumor with only a few hundred cases reported in the last half century [1]
Cardiac fibromas are rare benign cardiac neoplasms, most frequently occurring in the pediatric population; with very rare cases identified in adults
Cardiac fibroma is a rare benign primary tumor with only a few hundred cases reported in the last half century [1]
Summary
Cardiac fibroma is a rare benign primary tumor with only a few hundred cases reported in the last half century [1]. Subsequent chest CT showed a mass lesion anterior to the right ventricle and involving the ventricular wall (Fig. 1a). Transthoracic echocardiography (TTE) demonstrated a large nonmobile echo-bright density in the right ventricular free wall (Fig. 2). The histopathological features were consistent with cardiac fibroma She subsequently, underwent complete surgical resection of her tumor through median sternotomy under standard cardiopulmonary bypass, bicaval and aortic cannulation without aortic cross-clamping. A large glistening grey-red firm tumor (weight: 58 g, dimension: 60 × 42 × 35 mm) arising from the right ventricular free wall was successfully excised with careful dissection. Remaining extremely thin myocardial tissue of the right ventricular free wall was excised to create a large defect (Fig. 5a, b, c, and d).
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