J Pediatr Intensive Care 2018; 07(01): 059-061
DOI: 10.1055/s-0037-1604018
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Rare Etiology of Acute Embolic Stroke in a 17-Year-Old Girl: Cardiac Papillary Fibroelastoma

Tanya Chadha
1   Department of Pediatrics, Wolfson Children's Hospital, Jacksonville, Florida, United States
2   Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida, United States
,
Susan Cooke
1   Department of Pediatrics, Wolfson Children's Hospital, Jacksonville, Florida, United States
2   Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida, United States
,
Michael S. Shillingford
1   Department of Pediatrics, Wolfson Children's Hospital, Jacksonville, Florida, United States
2   Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida, United States
,
Eric Ceithaml
1   Department of Pediatrics, Wolfson Children's Hospital, Jacksonville, Florida, United States
2   Department of Pediatrics, University of Florida College of Medicine, Gainesville, Florida, United States
› Author Affiliations
Further Information

Publication History

20 April 2017

28 May 2017

Publication Date:
19 July 2017 (online)

Abstract

A cardiac papillary fibroelastoma is a benign, pedunculated tumor with strand-like projections arising from the endocardium. While often discovered incidentally, these tumors can embolize resulting in major neurologic events. There is a dearth of pediatric literature describing the necessity and optimal timing of surgical intervention for this rare primary cardiac tumor after a cerebrovascular event. We report an interesting case and the subsequent management dilemma in a teenage patient presenting with acute embolic strokes secondary to an aortic valve papillary fibroelastoma. Despite its rarity, a high index of suspicion should be maintained for such tumors in previously healthy children presenting with acute stroke.

 
  • References

  • 1 Gowda RM, Khan IA, Nair CK, Mehta NJ, Vasavada BC, Sacchi TJ. Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases. Am Heart J 2003; 146 (03) 404-410
  • 2 Klarich KW, Enriquez-Sarano M, Gura GM, Edwards WD, Tajik AJ, Seward JB. Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation. J Am Coll Cardiol 1997; 30 (03) 784-790
  • 3 Sun JP, Asher CR, Yang XS. , et al. Clinical and echocardiographic characteristics of papillary fibroelastomas: a retrospective and prospective study in 162 patients. Circulation 2001; 103 (22) 2687-2693
  • 4 Kobayashi Y, Saito S, Yamazaki K, Kurosawa H. Multiple papillary fibroelastoma in left ventricle associated with obstructive hypertrophic cardiomyopathy. Interact Cardiovasc Thorac Surg 2009; 9 (05) 921-922
  • 5 Boodhwani M, Veinot JP, Hendry PJ. Surgical approach to cardiac papillary fibroelastomas. Can J Cardiol 2007; 23 (04) 301-302
  • 6 Eishi K, Kawazoe K, Kuriyama Y, Kitoh Y, Kawashima Y, Omae T. Surgical management of infective endocarditis associated with cerebral complications. Multi-center retrospective study in Japan. J Thorac Cardiovasc Surg 1995; 110 (06) 1745-1755
  • 7 Gillinov AM, Shah RV, Curtis WE. , et al. Valve replacement in patients with endocarditis and acute neurologic deficit. Ann Thorac Surg 1996; 61 (04) 1125-1129 , discussion 1130
  • 8 Piper C, Wiemer M, Schulte HD, Horstkotte D. Stroke is not a contraindication for urgent valve replacement in acute infective endocarditis. J Heart Valve Dis 2001; 10 (06) 703-711