左室流出路に発生した乳頭状線維弾性腫の1例

Papillary Fibroelastoma of the Left Ventricular Outflow Tract；Report of a Case

はじめに　原発性心臓腫瘍の頻度は剖検例の0.02～0.3％であり，そのうち乳頭状線維弾性腫（PFE）は粘液腫，脂肪腫に次いで3番目の頻度で約8～10％である．左心室内腔より発生した場合，小さいとその発見は困難である．われわれは重症僧帽弁閉鎖不全症による心不全で入院した患者で，左室流出路にある小さなPFEを術前に発見し，摘出術を行ったので報告する．

Papillary fibroelastoma （PFE） is a rare and benign primary cardiac neoplasm. The incidence of PFE in the left ventricle is lower than that in other parts of the heart. A 67-year-old female was referred to our cardiology department for treatment of severe cardiac failure due to mitral regurgitation. Transthoracic and transesophageal echocardiography coincidently revealed a 1.0 cm highly mobile mass attached by a stalk to the outflow tract wall of the left ventricle. The mass was easily detected using endoscope and successfully removed without any postoperative complications and was pathologically diagnosed as a PFE. In this report, we discuss the echocardiographic character of PFE and the usefulness of endoscope for the identification and resection of a PFE in the left ventricle.