A rare case of ventricular tachycardia caused by an intramyocardial fibroma with successful surgical resection in an adult

TL;DR

A rare case of heart tumor causing abnormal heart rhythm was successfully treated with surgery in an adult.

Contribution

Demonstrates successful surgical resection of an intramyocardial fibroma causing ventricular tachycardia in an adult.

Findings

Surgical resection of a large intracardiac fibroma resolved ventricular tachycardia in a 42-year-old male.

MRI was effective in identifying the fibroma's size and location without myocardial infiltration.

Successful surgery allowed discharge without the need for a defibrillator.

Abstract

Cardiac fibromas are extremely rare in adults. The preferred treatment is surgical resection, but antiarrhythmic medications or heart transplantation have also been used previously. The cardiac imaging, particularly MRI, can be useful to help delineate between primary cardiac tumors, and surgical factors such as the extent/size of the fibroma, involvement of the coronary arteries or mitral apparatus and amount of residual myocardium influence whether surgical resection is feasible.

A 42-year-old male presented with a wide-complex tachycardia, unresponsive to amiodarone. An echocardiogram was performed which showed a possible posterior wall mass. A cardiac MRI showed a well circumscribed lateral wall intracardiac fibroma, measuring 5.2 × 5.1 × 3.8 cm with preserved function. Surgical resection was successful, and he was discharged without a defibrillator.

Cardiac fibromas are encapsulated tumors which do not infiltrate myocardium and should be surgically resected if possible.

The online version contains supplementary material available at 10.1186/s13019-024-02986-3.

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