Heart
Cardiac tumors - benign
Fibroma

Author: Nat Pernick, M.D. (see Authors page)

Revised: 19 March 2018, last major update November 2013

Copyright: (c) 2007-2018, PathologyOutlines.com, Inc.

PubMed Search: Fibroma [title] heart pathology

Cite this page: Pernick, N. Fibroma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/hearttumorfibroma.html. Accessed April 24th, 2018.
Definition / general
  • Rare but common among cardiac tumors in children
  • Benign, congenital, probably a hamartoma; rare cases may represent fibromatosis with aggressive behavior
  • Presents with heart failure or cyanosis in 1/3, syncope or arrhythmia in 1/3, incidental / asymptomatic in 1/3
  • Found in 10% of Gorlin syndrome patients (nevoid-basal cell carcinoma syndrome)
Case reports
Treatment
Gross description
  • Discrete bulging mass, nearly always solitary, often calcification
Gross images

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Large septal mass on anterior and right lateral border

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Homogeneous mass was easily shelled out

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Large circumscribed
mass in RV wall
compresses RV cavity


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Ventricular mass

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Intraoperative images

Microscopic (histologic) description
  • Bland fibroblasts and collagen
  • Calcification common
  • More cellular in infants and children
  • Mitotic figures in infants only
  • Margin is infiltrative
  • Occasionally perivascular lymphocytes and histiocytes, elastic fibers, myxoid stroma
Microscopic (histologic) images

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Cellular lesion in infant
with perivascular
lymphocytes and
minimal collagen
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Tumor with collagen deposition

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Cardiac muscle at periphery, central fibroma cells

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Calcification


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Trichrome: abundant
collagen (more
common in older
children / adults)
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Infiltrative margin

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von Gieson elastin stain shows elastic fibers



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Prominent fibrous tissue

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Infiltrative margin

Electron microscopy description
  • Fibroblasts with extensive endoplasmic reticulum but few cellular organelles
  • Incompletely developed / absent basement membrane, ramifying cytoplasmic processes, central nucleus with distinct nucleolus
  • Cells of intermediate differentiation with smooth muscle myofilaments
Differential diagnosis