Cardiac Papillary Fibroelastoma as a Cause of Recurrent Ischemic Strokes: The Diagnostic Value of Serial Transesophageal Echocardiography

Cardiac Papillary Fibroelastoma as a Cause of Embolic Stroke: Ultrasound and Histopathological Characteristics

“…In this paper, the detailed characteristics of the CPF on (1,9,11). The myxoma, vegetation, and intracardiac thrombus should be differentiated from the CPF on TEE.…”

“…In contrast, TEE helps to differentiate CPF from other intracardiac tumors, in particular myxoma and the vegetation of endocarditis (19). When the CPF is large, TEE can delineate a clear surface with a bright echoic core of collagen fibers or fibrous tissue and a stippled edge with vibration at the tumor-blood interface (11,15,20 (4,21,22), as well as the CPF itself (4,7,8) (4,5). The previous reports have provided no firm evidence-based guidelines regarding the use and duration of anticoagulation post excision of CPF (4,16).…”

“…The previous reports have provided no firm evidence-based guidelines regarding the use and duration of anticoagulation post excision of CPF (4,16). Some reported cases continued (16,24) and some discontinued anticoagulation postoperatively (11,23 …”

Valvular Strands and Ischemic Stroke

“…When TEE is contraindicated, multislide computed tomography may prove to be an alternative diagnostic technique [23]. TEE is valuable not only in detecting the cardiac structures, but particularly in characterizing its attachment to the underlying valve, its location, mobility and relation to other cardiac structures [8, 13, 24]. However, it is important to note that the definitive diagnosis of a valvular strand is still histopathologic in its nature, while it is almost impossible to distinguish between fibroma, fibroelastoma, myxoma or thrombi using TEE alone [6, 8, 25].…”

A Caudal Mesencephalic Infarct Presenting Only with Tetra-Ataxia and Tremor

“…especially in symptomatic or large mobile tumors [4,[7][8][9][10][11][12]19] . Its pedicle makes removal of CPF usually easy.…”