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Background <p>Papillary fibroelastomas typically arise from the cardiac valves, whereas cardiac myxomas rarely originate from the valves. Distinguishing these tumors intraoperatively can be challenging.</p> Case presentation <p>An 81-year-old man was referred for evaluation of an incidental cardiac mass. Transesophageal echocardiography revealed a mobile 10-mm mass attached to the P1 segment of the posterior mitral leaflet. Minimally invasive cardiac surgery <i>via</i> a right mini-thoracotomy allowed satisfactory exposure of the mitral valve. Intraoperative findings and frozen section analysis suggested a myxoma, prompting excision with a margin that included the tumor attachment. However, the final histopathological examination revealed papillary fibroelastoma. The postoperative course was uneventful, and the mitral valve function was preserved.</p> Conclusions <p>Papillary fibroelastomas and myxomas can be difficult to differentiate intraoperatively. Surgical decision-making should balance adequate tumor resection with preserved valve function when a diagnosis is uncertain.</p>

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Papillary fibroelastoma of the mitral valve initially suspected as myxoma: a case report of resection via minimally invasive approach

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月19日

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  • Shota Inoue,
  • Hayate Nomura,
  • Yukihiro Hayatsu

摘要

Background

Papillary fibroelastomas typically arise from the cardiac valves, whereas cardiac myxomas rarely originate from the valves. Distinguishing these tumors intraoperatively can be challenging.

Case presentation

An 81-year-old man was referred for evaluation of an incidental cardiac mass. Transesophageal echocardiography revealed a mobile 10-mm mass attached to the P1 segment of the posterior mitral leaflet. Minimally invasive cardiac surgery via a right mini-thoracotomy allowed satisfactory exposure of the mitral valve. Intraoperative findings and frozen section analysis suggested a myxoma, prompting excision with a margin that included the tumor attachment. However, the final histopathological examination revealed papillary fibroelastoma. The postoperative course was uneventful, and the mitral valve function was preserved.

Conclusions

Papillary fibroelastomas and myxomas can be difficult to differentiate intraoperatively. Surgical decision-making should balance adequate tumor resection with preserved valve function when a diagnosis is uncertain.