Images in cardiovascular medicine. Fibroelastoma and embolic stroke.

Abstract

HomeCirculationVol. 97, No. 16Fibroelastoma and Embolic Stroke Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree AccessOtherPDF/EPUBFibroelastoma and Embolic Stroke Frank J. Conte and Alan S. Katz Frank J. ConteFrank J. Conte From private practice (F.J.C.) and The Miriam Hospital, Division of Cardiology (A.S.K.), Providence, RI 02906. Search for more papers by this author and Alan S. KatzAlan S. Katz From private practice (F.J.C.) and The Miriam Hospital, Division of Cardiology (A.S.K.), Providence, RI 02906. Search for more papers by this author Originally published28 Apr 1998https://doi.org/10.1161/01.CIR.97.16.1648Circulation. 1998;97:1648A 40-year-old healthy woman presented with an acute expressive aphasia and right hemiparesis. An angiogram revealed an occluded left middle cerebral artery consistent with an embolic stroke. In the Figure, panel A, a four-chamber view from a transesophageal echocardiogram, shows a 1.5-cm spherical mass on the posterior mitral valve leaflet (white arrow; LA indicates left atrium; LV, left ventricle; and AML, anterior mitral leaflet). The differential diagnosis of this lesion included thrombus, vegetation, mitral annual calcification, and tumor. Successful surgical excision of the mass and mitral valve reconstruction with implantation of a Carpentier ring was performed. Panel B is a cut section of the mass stained with hematoxylin-eosin magnified 20×. The image demonstrates the characteristic pathological findings of a fibroelastoma, which include multiple papillary fronds composed of a central core of connective tissue, collagen, and elastic fibers surrounded by hyperplastic endocardial cells. It is likely that one of the fronds dislodged and embolized. After 1 year, the motor and speech deficits have improved.The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke’s Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.Download figureDownload PowerPointFootnotesCorrespondence to Alan S. Katz, MD, Division of Cardiology, The Miriam Hospital, 164 Summit Ave, Providence, RI 02906. Previous Back to top Next FiguresReferencesRelatedDetailsCited By Neely J, Carpenter J, Hsu W, Jordan L and Restrepo L (2006) Cerebral infarction in Hunter syndrome, Journal of Clinical Neuroscience, 10.1016/j.jocn.2005.12.038, 13:10, (1054-1057), Online publication date: 1-Dec-2006. Outomuro D, del Riego H, Grana D and Milei J (2006) Unusual location in the left ventricular outflow tract and atypical symptoms of cardiac papillary fibroelastoma, Journal of Cardiovascular Medicine, 10.2459/01.JCM.0000247325.03278.39, 7:10, (768-770), Online publication date: 1-Oct-2006. Nawaz M, Lander A, Schussler J, Grayburn P, Hamman B and Roberts W (2006) Tumor Excision Versus Valve Replacement for Papillary Fibroelastoma Involving the Mitral Valve, The American Journal of Cardiology, 10.1016/j.amjcard.2005.11.018, 97:5, (759-764), Online publication date: 1-Mar-2006. Gowda R, Khan I, Nair C, Mehta N, Vasavada B and Sacchi T (2003) Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases, American Heart Journal, 10.1016/S0002-8703(03)00249-7, 146:3, (404-410), Online publication date: 1-Sep-2003. Sastre-Garriga J, Molina C, Montaner J, Mauleón A, Pujadas F, Codina A and Álvarez-Sabín J (2000) Mitral papillary fibroelastoma as a cause of cardiogenic embolic stroke: report of two cases and review of the literature, European Journal of Neurology, 10.1046/j.1468-1331.2000.00092.x, 7:4, (449-453), Online publication date: 1-Jul-2000. April 28, 1998Vol 97, Issue 16Article InformationMetrics Copyright © 1998 by American Heart Associationhttps://doi.org/10.1161/01.CIR.97.16.1648 Originally publishedApril 28, 1998 PDF download Advertisement