Conservative management of left ventricle cardiac fibroma in an adult asymptomatic patient

Abstract

Primary cardiac tumours are rare with an autopsy frequency of 0.001–0.03% and approximately 90% of them are benign. Among these, cardiac fibromas represent a minority and, together with rhabdomyomas, are themost common benign cardiac tumours in paediatric patients. However, their occurrence in the adult patient is uncommon. Most originate from the left ventricle (LV) or interventricular septum. Patients with cardiac fibroma usually present with chest discomfort or pain, syncope, heart failure, cyanosis, arrhythmias or even sudden death but approximately one third of patients diagnosed with cardiac fibroma are asymptomatic and the tumour is discovered incidentally [1]. There is a general agreement that surgical treatment should be performed whenever the cardiac fibroma is causing symptoms. In these patients, surgical options include complete surgical excision, partial resection or orthotopic heart transplantation. Indication for surgical treatment remains controversial in patients who are strictly asymptomatic. We report the case of an asymptomatic adult patient presenting with a giant LV cardiac fibroma and for whom we have opted for a conservative management. A 39-year-oldwomanwas referred to our institution for a LV cardiac mass discovered incidentally during transthoracic echocardiography performed for an unrelated reason. The patient had no personal or familial history of cardiovascular disease and presented no risk factors.