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(Circulation. 2002;106:386.)
© 2002 American Heart Association, Inc.

Images in Cardiovascular Medicine

Giant Right Ventricular Fibroma in an Infant

Massimo A. Padalino, MD; Cristina Basso, MD, PhD; Gaetano Thiene, MD; Giovanni Stellin, MD

From the Departments of Cardiovascular Surgery (M.A.P., G.S.) and Pathology (C.B., G.T.), University of Padova Medical School, Padova, Italy.

Correspondence and reprint requests to G. Stellin, MD, Department of Cardiac Surgery, University of Padova Medical School, Via Giustiniani, 2, 35128-Padova, Italy. E-mail giovanni.stellin@unipd.it

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Apreviously asymptomatic 5-month-old girl was admitted because of polypnea and dyspnea, with signs of moderate heart failure. Physical examination showed diffuse wheezing, a 3/6 systolic precordial murmur, and an enlarged liver 4 cm from the right costal border. Chest x-ray demonstrated an increased cardiothoracic index (0.52) with pulmonary congestion. ECG showed sinus rhythm. An episode of ventricular tachycardia (175 bpm) occurred soon after hospitalization. Two-dimensional echocardiography showed a huge, roundish mass (6x5 cm in size) at the right ventricular (RV) free wall site, which was causing RV outflow tract obstruction (49 mm Hg). MRI (Figure 1) confirmed a solid mass, 6x4x5 cm in size, involving the RV anterior myocardial wall and causing severe RV cavity reduction. Main pulmonary artery and aorta were cranially and posteriorly dislocated.

View larger version (69K): [in this window] [in a new window]   Figure 1. MRI (A, axial plane; B, sagittal plane) shows a huge, solid mass, 6x4x5 cm in size, involving the RV anterior myocardial wall, causing severe RV cavity reduction and RV outflow obstruction.

At cardiopulmonary bypass, the mass was finally isolated and resected, through gentle dissection of myocardium from epicardium and endocardium, and the RV free wall was reconstructed with a 0.6-mm polytetrafluoroethylene patch. An intraoperative biopsy showed abundant proliferation of fibroblasts with collagen deposition, which are diagnostic for cardiac fibroma (Figure 2A). The excised, rounded mass, 81 g in weight and 6x5 cm in size (Figure 2B), appeared firm, white, and whorled.

View larger version (53K): [in this window] [in a new window]   Figure 2. A, . . . [Full Text of this Article]

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