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Unusual Location of a Papillary Fibroelastoma Causing a Multi-territorial Stroke
Timothy G Scully1, Edmond Wong1, Timothy Barton1
1Department of Cardiology, Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia.
Journal of Cardiovascular Echography
|May 31, 2024
Summary
A cardiac papillary fibroelastoma, not an atrial myxoma, caused a stroke in a patient lacking typical risk factors. This finding reveals a new way heart tumors can lead to cerebral events.
Area of Science:
- Cardiology
- Neurology
- Pathology
Background:
- Cerebrovascular events, or strokes, are often linked to traditional risk factors.
- Intracardiac masses are a less common cause of stroke, with atrial myxomas being a primary concern.
Observation:
- A 56-year-old male experienced a multi-territorial stroke despite having no conventional cerebrovascular risk factors.
- Transesophageal echocardiography identified an intracardiac lesion on the left atrial wall, initially suspected to be an atrial myxoma.
Findings:
- Surgical removal of the lesion revealed it was a papillary fibroelastoma with an attached thrombus.
- This case demonstrates a previously unrecognized mechanism of cardioembolic stroke originating from a papillary fibroelastoma.
Implications:
- Papillary fibroelastomas should be considered in the differential diagnosis of intracardiac masses causing embolic events.
- Understanding this novel mechanism can improve stroke risk assessment and patient management.
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