Abstract：
BACKGROUND Papillary fibroelastoma is the most common type of benign primary cardiac tumor and is usually asymptomatic. However, tumor fragments or surface thrombus can embolize and cause transient ischemic attacks, strokes, or myocardial infarction. This report describes a 76-year-old woman who presented with dysarthria and right-sided weakness due to a stroke associated with a left atrial papillary fibroelastoma. CASE REPORT A 76-year-old woman visited the Emergency Department because she had right-sided weakness and dysarthria from 12 h ago. Brain magnetic resonance image was done at the Emergency Department, showing multiple small embolic, acute infarction in left basal ganglia and fronto-temporo-parietal lobes. Transthoracic and transesophageal echocardiogram showed a hypermobile echogenic mass (0.8×1.5 cm) with villous surface on the orifice of left atrial appendage. Twenty-four-hour Holter monitoring was performed to evaluate the cause of cerebral infarction, and there was no paroxysmal atrial fibrillation. Thoracic computed tomography angiography also showed a sea anemone-shaped mass around the left atrial appendage. Cardiac tumor excision was done via a lower partial sternotomy. Histopathologic analysis showed multiple delicate fronds, and the avascular fibroelastic cores were lined by a single layer of CD31-positive endothelial cells. Histopathologic findings were consistent with papillary fibroelastoma. The patient was discharged without any other complications on day 30 of hospitalization. CONCLUSIONS This case highlights the importance of cardiac imaging in patients with acute stroke, including transthoracic and transesophageal echocardiography, which can show the typical imaging features of papillary fibroelastoma and other intracardiac sources of embolus.
摘要：
背景技术乳头状纤维弹性瘤是最常见的良性原发性心脏肿瘤类型,通常无症状。然而,肿瘤碎片或表面血栓可栓塞并引起短暂性脑缺血发作，笔画,或者心肌梗塞.该报告描述了一名76岁的女性，由于与左心房乳头状纤维弹性瘤相关的中风而出现构音障碍和右侧无力。病例报告一名76岁的妇女访问了急诊科，因为她从12小时前就患有右侧无力和构音障碍。脑部磁共振图像是在急诊科完成的，显示多个小栓塞，左侧基底节和额颞顶叶急性梗死。经胸和经食道超声心动图显示，左心耳孔上有绒毛表面的高动回声肿块（0.8×1.5cm）。进行24小时动态心电图监测以评估脑梗死的原因，没有阵发性心房颤动.胸部计算机断层扫描血管造影也显示左心耳周围有海葵状肿块。心脏肿瘤切除是通过下部分胸骨切开术完成的。组织病理学分析显示有多个娇嫩的叶状体,无血管纤维弹性核由单层CD31阳性内皮细胞排列。组织病理学结果与乳头状纤维弹性瘤一致。患者在住院第30天出院，无任何其他并发症。结论本病例强调了心脏影像学在急性卒中患者中的重要性。包括经胸和经食道超声心动图,可以显示乳头状纤维弹性瘤和其他心内栓子来源的典型影像学特征。
