Key result
Surgical excision of an aortic valve papillary fibroelastoma in a 68-year-old woman with recurrent cardioembolic stroke resulted in an uneventful postoperative course with no neurologic complications.
Why the study?
Papillary fibroelastoma is clinically important due to risks of systemic embolism including cardioembolic stroke, but reports in Japan are rare.
Case Report (n=1)
No
Transesophageal echocardiography is essential for identifying rare cardiac tumors like papillary fibroelastoma in patients with recurrent embolic strokes of undetermined source when transthoracic echocardiography is negative.
Hypothesis-generating for surgical excision of aortic valve papillary fibroelastoma in recurrent cardioembolic stroke; prospective trials needed before wider adoption.
要旨：症例は68歳の女性．5カ月前からの歩行障害，3カ月前の頭部mriで新旧混在する多発脳梗塞を認めた．2カ月前からは右手のしびれ感，1カ月前から構音障害，右手の不全麻痺も出現し，7日前からは嚥下障害，6日前の頭部mriで新たな梗塞巣が出現し，緊急入院となった．頭部mriでは両側半球に散在する梗塞像がみられたが，血液検査，経胸壁心臓超音波検査，頸動脈超音波検査，胸部造影ct，ホルター心電図に異常所見はなく，血液培養は陰性であった．経食道心臓超音波検査では，大動脈弁無冠尖にイソギンチャク様の疣腫を認め，心臓原発腫瘍の可能性が高いと判断し，腫瘍切除術を施行した．病理所見は乳頭状線維弾性腫であり，術後脳梗塞の再発も認めていない．乳頭状線維弾性腫は脳塞栓症を含む全身性塞栓症を来すことで臨床的に重要であるが，本邦での報告は稀であり，文献的考察を加えて報告する．
No takes yet. Share an insight, caveat, or question.
Kamamura et al. (2021) conducted a case report in Recurrent multiple cardioembolic stroke due to papillary fibroelastoma (n=1). Surgical excision was evaluated on Postoperative course and neurologic complications. Surgical excision of an aortic valve papillary fibroelastoma in a 68-year-old woman with recurrent cardioembolic stroke resulted in an uneventful postoperative course with no neurologic complications.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: