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Background <p>Spontaneous rupture of the right atrium is an extremely rare event, most commonly associated with trauma, infarction, or malignant infiltration. Papillary fibroelastoma is a benign cardiac tumor typically involving valvular surfaces and has not been previously reported as a cause of atrial wall rupture.</p> Case presentation <p>We describe a 53-year-old woman presenting with sudden hemodynamic collapse due to massive pericardial effusion. Computed tomography revealed hemopericardium without evidence of aortic or coronary rupture. Emergency surgery identified active bleeding from the right atrial free wall, with a friable nodular lesion in direct continuity with the rupture site. Histologic appearance and gross morphology were consistent with papillary fibroelastoma. The patient recovered uneventfully after surgical repair.</p> Conclusions <p>This case highlights an unprecedented presentation of papillary fibroelastoma causing spontaneous right atrial rupture. Prompt imaging and surgical exploration are essential for diagnosis and management of unexplained cardiac tamponade.</p>

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Spontaneous right atrial rupture caused by a papillary fibroelastoma: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月22日

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  • Mattia Vinciguerra,
  • Emmanouela Chourda,
  • Gioacchino Galardo,
  • Giada Della Grotta,
  • Fabio Miraldi,
  • Ernesto Greco,
  • Antonio Barretta

摘要

Background

Spontaneous rupture of the right atrium is an extremely rare event, most commonly associated with trauma, infarction, or malignant infiltration. Papillary fibroelastoma is a benign cardiac tumor typically involving valvular surfaces and has not been previously reported as a cause of atrial wall rupture.

Case presentation

We describe a 53-year-old woman presenting with sudden hemodynamic collapse due to massive pericardial effusion. Computed tomography revealed hemopericardium without evidence of aortic or coronary rupture. Emergency surgery identified active bleeding from the right atrial free wall, with a friable nodular lesion in direct continuity with the rupture site. Histologic appearance and gross morphology were consistent with papillary fibroelastoma. The patient recovered uneventfully after surgical repair.

Conclusions

This case highlights an unprecedented presentation of papillary fibroelastoma causing spontaneous right atrial rupture. Prompt imaging and surgical exploration are essential for diagnosis and management of unexplained cardiac tamponade.