Surgical resection of primary cardiac fibroma of the left ventricle in an adult woman: case report

Figures

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  Figure 1. Cardiac magnetic resonance imaging of a large left ventricular mass. (A) T2-weighted cine sequence showing a well-circumscribed hypointense intramyocardial mass in the left ventricle (arrow), consistent with low water content and fibrous tissue. (B) Pre- and early post-contrast images demonstrating the mass without central necrosis, causing mild distortion of the left ventricular cavity. (C) Late gadolinium enhancement sequence showing intense and homogeneous enhancement of the mass, typical of cardiac fibroma, while adjacent myocardium appears normal.

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  Figure 2. Intraoperative views of the cardiac fibroma. (A) Gross appearance of cardiac fibroma bulging from the left ventricular apex after sternotomy (arrow). (B) Tumour resection in progress, showing well-demarcated fibrous tissue being dissected from the ventricular wall (arrow). (C) Left ventricular wall after complete excision of the mass, with preserved myocardial wall (arrow).

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  Figure 3. Surgical repair of the left ventricular wall. (A and B) Reinforcement of the left ventricular wall using an autologous pericardial patch. (C) Final closure of the left ventricular free wall with two pericardial strips and additional sealing with BioGlue.

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  Figure 4. Histopathological examination (200×) of the resected cardiac mass (haematoxylin and eosin stain). The specimen demonstrates abundant dense fibrous tissue interspersed with residual myocardial fibres, without evidence of cellular atypia or malignancy, consistent with the diagnosis of cardiac fibroma.