A Large Cardiac Fibroma Lied in the Interventricular Septum of an Adult with Exertional Pain and Palpitation: A Case Report

Introduction:
Cardiac fibromas are rare primary tumors that mainly affect children and teenagers and are rarely found in adults. The patients may be asymptomatic or may present their disease with arrhythmia or even heart failure. However, bizarre presentations can be found. The present study aimed to report a case of cardiac fibroma presented with exertional dyspnea and palpitation.
Case Presentation:
A 29-year-old Caucasian male presented with the symptoms of exertional dyspnea and palpitation in the emergency room. Tachycardia was evident in physical examination and electrocardiography. On the echocardiographic assessment, a hyperechogenic mass was found in the proximal part of the anterior interventricular septum with calcified spots and without defined capsules around the mass suggestive of lipoma or other infiltrative mesenchymal tumors. Cardiac magnetic resonance assessment with fat suppression mode ruled out lipoma and bolded fibroma diagnosis. The patient underwent excisional surgery and survived the condition. On pathology and immunohistochemistry evaluation, the diagnosis of fibroma was confirmed. The patient survived the surgery with no morbidities. Hemodynamic study revealed no findings suggestive of heart failure.
Conclusions:
Cardiac fibroma is a rare tumor in adults and usually happens in children under five years old. This condition can be diagnosed in echocardiography and the subsequent cardiac magnetic resonance imaging. The tumor is usually featured with central calcification.