Rapid development of a papillary fibroelastoma in the aortic valve: report of a case.

We report a case of a fast-growing cardiac papillary fibroelastoma (CPF) arising in the aortic valve. A 71-year-old woman was referred to a cardiologist for investigation of palpitations. Cardiac catheterization, coronary angiography, and echocardiography showed no stenosis of the coronary arteries, nor any other cardiovascular abnormalities. However, 12 months later she was referred to our hospital for further investigations when she began experiencing chest discomfort on exertion. This time, echocardiography showed an abnormal mass arising from the aortic valve, floating between the left sinus of Valsalva and the ascending aorta. Considering the risk of an embolic event, we performed semi-emergency surgery to remove the tumor, preserving the aortic valve. The resected tumor was 16 x 7 mm, and sea anemone-like, with many villus projections. It was diagnosed as papillary fibroelastoma. Such rapid development of CPF is rare.

The expression of thymidine phosphorylase is a prognostic predictor for the intravesical recurrence of superficial bladder cancer.

BACKGROUND: Thymidine phosphorylase (TP), also known as platelet-derived endothelial cell growth factor, has been implicated in the angiogenesis of bladder cancer. The aim of this study is to investigate the association between TP expression and the clinicopathologic findings, and the prognostic value. METHODS: TP immunohistochemical staining was performed in specimens from 71 patients (50 men and 21 women) with superficial bladder cancer (pTa or pT1). Thirty-nine patients had received intravesical instillation of tetrahydropyranyladriamycin (THP) after transurethral resection (TUR) and the other 32 had not. For immunohistochemistry, paraffin-embedded specimens were stained with mouse monoclonal antibody against TP. When more than 10% of tumor cells were positively stained, staining was defined as positive. The correlations between TP immunostaining and clinicopathological features were analyzed. Multivariate analysis, using the Cox proportional hazard model, was performed to determine the risk factors for intravesical recurrence. RESULTS: Specimens from 29 of the 71 patients (19 men and 10 women) were positive for TP. The expression of TP was not correlated with age, sex, histological grade, multiplicity, or morphology. Also, TP expression was not associated with whether the cases were primary or recurrent. Multivariate analysis demonstrated that the decreased expression of TP and the use of THP instillation could be independent predictors of a higher rate of intravesical recurrence-free bladder cancer. CONCLUSION: The present study suggests that immunohistochemical TP staining is useful for predicting the intravesical recurrence of superficial bladder cancer after Transurethral resection of bladder tumor (TUR-Bt).