Cardiac papillary fibroelastoma: The need for a timely diagnosis

Figure 1 Autopsy specimen of the heart demonstrating a cardiac papillary fibroelastoma on the aortic valve. Note the large bulky tan-white non-encapsulated, rubbery, firm lesion with short pedicle and multiple papillary fronds on the aortic valve measuring 1.5 cm × 1.0 cm in size, completely occluding the right coronary ostium (blue circle).

Figure 2 Microscopic photograph of the cardiac papillary fibroelastoma. A: Histological section of the mass shows benign papillary lesion comprised of a single layer of endocardial cells overlies a thin layer of mucopolysaccharide matrix and underlying, almost acellular, avascular stroma composed predominantly of elastic fibers; B: Elastin stain reveals concentric elastin fibres within the papillary excrescences.

Figure 3 Transthoracic echocardiogram showing a cardiac papillary fibroelastoma on the aortic valve (marked).