We sought to determine the clinical and echocardiographic characteristics of papillary
PFE is a rarely encountered cardiac tumor about which relatively little is known.
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 PFE.
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.
PFEs are associated with embolism, can be diagnosed with echocardiography, are often
an incidental clinical finding and do not cause valvular dysfunction.