Papillary fibroelastoma: Echocardiographic characteristics for diagnosis and pathologic correlation

Kyle W. Klarich, Maurice Enriquez-Sarano, George M. Gura, William D. Edwards, A. Jamil Tajik, James B. Seward

Research output: Contribution to journalReview articlepeer-review

247 Scopus citations


Objectives. We sought to determine the clinical and echocardiographic characteristics of papillary fibroelastoma (PFE). Background. PFE is a rarely encountered cardiac tumor about which relatively little is known. Methods. Institutional records were reviewed for the years 1980 to 1995 for patients with pathologic or echocardiographic diagnosis of PFE. Group 1 included 17 patients with the pathologic diagnosis of PFE who also underwent echocardiography. Echocardiographic features of PFE were established in group 1. Group 2 included 37 patients with only echocardiographic evidence of FFE. Results. In group 1, 7 (41.2%) of 17 patients had symptoms related to PFE. Neurologic events occurred in 5 (29.4%) of 17 patients. All patients had the tumor surgically removed. During follow-up, no new embolic events occurred. Echocardiographic characteristics of PFE included a small tumor (12.1 ± 6.5 x 9.0 ± 4.3 mm), usually pedunculated (14 [94%] of 17 patients) and mobile, with a homogeneous speckled pattern and a characteristic stippling along the edges. PFEs were most common on valvular surfaces (12 [60%] of 20 PFEs) but were not uncommon on other endocardial surfaces (8 [40%] of 20 PFEs). The tumor did not cause valvular dysfunction. In group 2, 16 (43%) of 37 patients were asymptomatic. Five patients (13.5%) had a previous neurologic event. During follow-up (mean 31 months, range 1 to 77), nine neurologic events occurred. Conclusions. PFEs are associated with embolism, can be diagnosed with echocardiography, are often an incidental clinical finding and do not cause valvular dysfunction.

Original languageEnglish (US)
Pages (from-to)784-790
Number of pages7
JournalJournal of the American College of Cardiology
Issue number3
StatePublished - Jul 1997

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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