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Int J Clin Exp Pathol 2011;4(3):307-311

Case Report
Left atrial myxoma with papillary fibroelastoma-like features

Abbas Agaimy , Thomas Strecker

Institute of Pathology and Center of Cardiac Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Germany

Received February 7, 2011; accepted February 27, 2011; Epub March 22, 2011; published March 31, 2011

Abstract: Although rare, papillary fibroelastoma (PFE) of the heart valves and atrial myxoma represent the two most common cardiac tumors.
Coexistence of these two lesions has been documented in rare case reports. We describe the case of a 77-year-old man who presented with
slightly progressive chest pain associated with dyspnea, fatigue and edema of the lungs. Transthoracic echocardiography detected a left atrial
mass that has been successfully excised. Histopathological examination showed a neoplasm combining features of both atrial myxoma and
PFE. However, close evaluation of the latter showed microscopic foci of myxomatous tissue within papillary cores, indicating that the PFE-like
component has developed around preexisting myxomatous tissue that served as a nidus for papillary fronds, probably by a process of fibrinous
microthrombosis, organization and endothelialisation. This unusual case may shed light on the pathogenesis of the PFE pattern.  

Keywords: Papillary fibroelastoma; myxoma, atrium; calretinin

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