Cardiac papillary fibroelastoma: an unusual source of cerebral embolism solved with local fibrinolysis.
Fibroelastoma is an infrequent tumor affecting mainly cardiac valves. Before echocardiography, it was an occasional autoptic finding. With the development of ultrasonographic techniques, it is currently possible to carry out diagnosis in vivo. We report the case of a young woman with cerebral ischemia who was successfully treated by intra-arterial fibrinolysis with complete clinical resolution. Transesophageal echocardiography (TEE) identified a papillary fibroelastoma on the posterior leaflet of the mitral valve. Surgical excision of the tumor was performed. Sudden cerebral or peripheral embolization is frequently linked to thrombotic material which surrounds the neoplasm, and thus can be successfully treated with local fibrinolysis.
Palazzuoli
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Institute of Internal Medicine, Le Scotte Policlinico, University of Siena, Viale Bracci, Italy.
Bruni
F
F
Pasqui
A
A
Puccetti
L
L
Bracco
S
S
Auteri
A
A
D005260:Female; D005350:Fibroma / Q000175:diagnosis*; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D006349:Heart Valve Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D010210:Papillary Muscles; D015912:Thrombolytic Therapy; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D014568:Urokinase-Type Plasminogen Activator