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Papillary fibroelastoma of the mitral valve in a 3-year-old child: case report
I C de Menezes1, J Fragata, F M Martins
1Pediatric Cardiology Unit and Department of Cardiothoracic Surgery, Hospital de Santa Cruz, Carnaxide, Portugal.
Insights
A rare cardiac tumor, papillary fibroelastoma, caused a child's stroke due to embolization. Early diagnosis via echocardiography and prompt surgical removal are crucial for preventing severe outcomes.
Area of Science:
- Cardiology
- Pediatric Neurology
- Oncology
Background:
- Primary cardiac tumors are rare in children.
- Embolization of cardiac masses can lead to significant neurological events like stroke.
- Papillary fibroelastomas are the most common cardiac tumors in adults, but rare in pediatric populations.
Observation:
- A 3.5-year-old boy presented with stroke symptoms.
- The stroke was secondary to embolization of an undiagnosed primary cardiac tumor.
- Two-dimensional echocardiography was used for diagnosis, confirmed intraoperatively.
Findings:
- Histological examination confirmed the cardiac tumor as a papillary fibroelastoma.
- The tumor was the source of the embolus causing the pediatric stroke.
- Patients with cardiac tumors causing embolization are often asymptomatic prior to the embolic event.
Implications:
- This case highlights the diagnostic challenge of asymptomatic cardiac tumors in children.
- Prompt surgical intervention is recommended to prevent severe embolic events and neurological damage.
- Early detection and management of cardiac tumors in pediatric patients are critical for improving outcomes.
Abstract:
A 3.5-year-old boy with stroke secondary to embolization of a primary cardiac tumor is presented. The diagnosis was made by two-dimensional echocardiography and confirmed intraoperatively. A papillary fibroelastoma was identified histologically. It is a rare condition and a diagnostic challenge, as patients are asymptomatic before embolization. In view of the severe consequences, prompt surgery is recommended.