Author + information
- Received April 20, 2011
- Revision received May 9, 2011
- Accepted May 31, 2011
- Published online February 21, 2012.
- Mazen S. Albaghdadi, MD⁎,
- Andrada Popescu, MD†,
- Charles J. Davidson, MD⁎,
- Patrick M. McCarthy, MD‡ and
- Preeti Kansal, MD⁎
A 44-year-old patient with back pain and dyspnea was noted to have calcifications overlying the lower mediastinum on a thoracic spine radiograph (A). Noncontrast chest computed tomography revealed a calcified mass projecting over the cardiac silhouette (B). Transthoracic echocardiogram showed a right ventricular (RV) mass occupying mid chamber to apex with minimal involvement of the RV outflow tract and tricuspid valve (Online Videos 1, 2, and 3). Right ventriculography with endomyocardial biopsy was unsuccessful, and cardiac magnetic resonance (CMR) imaging was obtained (Online Video 4). CMR demonstrated a septated mass occupying a large portion of the RV (C and D) (Online Videos 5 and 6). Heterogeneous hypointense T1 signal with absent early vascular enhancement on perfusion imaging, and avid delayed enhancement suggested a benign cardiac tumor comprised of fibrous tissue (E). In our patient, CMR provided important tissue and anatomic characterization for operative planning. Intraoperatively, care was taken to avoid the left anterior descending artery (delineated with blue marker) (Online Video 7). Successful surgical resection of the mass with RV reconstruction revealed a cardiac fibroma (F and G). Cardiac fibromas are extremely rare in adults, may be associated with arrhythmias and heart failure, and require surveillance imaging due to the potential for recurrence.
- Received April 20, 2011.
- Revision received May 9, 2011.
- Accepted May 31, 2011.
- American College of Cardiology Foundation