Papillary fibroelastoma, unusual cause of stroke in a young man: a case report
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CASE REPORT
Open Access
Papillary fibroelastoma, unusual cause of stroke in a young man: a case report Elisabetta Grolla1, Michele Dalla Vestra2, Giampaolo Zoffoli3, Riccardo D’Ascoli3, Adriana Critelli4, Rocco Quatrale4, Domenico Mangino3* and Fausto Rigo1
Abstract Background: Papillary fibroelastoma is the third most common primary benign tumor with an incidence of up to 0.33% in autopsy series; it accounts for approximately 75% of all cardiac valvular tumors. Case presentation: We describe a rare case of a 28-Year-old man that while playing football, had a sudden onset of neurological deficit: aphasia, right hemiparesis and right facial numbness. Transthoracic echocardiography (TTE) showed a 10x10 mm mass attached to the anterior mitral valve leaflet. The patient was treated surgically for the prevention of further embolic complications. Histologic examination of the resected mass revealed a papillary fibroelastoma. It is the third most frequent primary cardiac tumor, after myxoma and fibroma, and the most common primary tumor of heart valves. Despite the benign nature of this tumor, it carries very high risk of embolic complications. The successful complete resection of the papillary fibroelastoma is curative and the long-term postoperative prognosis is excellent. Conclusions: Differential diagnosis of cardiac masses requires clinical informations, laboratory tests, blood cultures and appropriate use of imaging modalities. Papillary fibroelastoma is a potential cause of embolic stroke in the young. The prompt surgical excision of papillary fibroelastoma is curative and the long-term postoperative prognosis is excellent. Keywords: Papillary fibroelastoma, Cardiac tumors, Cardioembolic stroke, Cerebrovascular disease, Case report
Background Papillary fibroelastoma is the third most common primary cardiac benign tumor with an incidence of up to 0.33% in autopsy series; it accounts for approximately 75% of all cardiac valvular tumors and affects men and women equally with a mean age of 60 years at diagnosis. Despite the benign nature of this tumor, it carries very high risk of embolic complications. Here we described a case of stroke in a 28-year-old man due to cerebral embolization originated from a cardiac papillary fibroelastoma. Case presentation A 28-years-old man was admitted to the Emergency Department of our Hospital for the sudden onset of aphasia, right facial numbness and right hemiparesis, * Correspondence: [email protected] 3 Department of Cardiac Surgery, Ospedale dell’Angelo, Venezia-Mestre, Italy Full list of author information is available at the end of the article
while playing football. He was not an athlete and never performed a medical examination for sports fitness. Nothing of significant emerged in the past medical history. Physical examination confirmed the neurological deficit, blood pressure was 120/80, heart rate 90 bpm, no carotid bruit detected. Blood tests (blood count, kidney and liver function, coagulation and electrolytes) were normal. Electrocardiography (ECG) show
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