Découverte fortuite d’un Fibroélastome Mitro-aortique

Abstract

Papillary fibroelastoma is a rare, benign primary tumor that can remain asymptomatic for a long time. The clinical presentation can include embolic events (ischemic stroke, mesenteric ischemia, limb ischemia) or valvular obstruction. The diagnosis is made using transthoracic and transesophageal echocardiography, as well as cardiac MRI. Surgical treatment is the only curative therapeutic option, preventing the risk of embolic recurrence. We report the case of a 65-year-old diabetic female patient hospitalized in neurology due to a hemorrhagic stroke, who was referred to cardiology for an etiological workup. The patient had untreated, previously unknown hypertension, which was the cause of the cerebral hemorrhage. In the echocardiogram, we found two masses : one on the anterior mitral valve and the other on the anterior right aortic sigmoid valve. A mitro-aortic fibroelastoma was suspected and confirmed by cardiac MRI. This is a serendipitous discovery of this benign tumor. We will review this rare entity, its diagnostic modalities, and therapeutic approaches.