Sastre-Garriga J, Molina C, Montaner J, Mauleón A, Pujadas F, Codina A, Alvarez-Sabín J
Unitat Cerebrovascular, Servei de Neurologia, Hospital General i Universitari Vall d'Hebron.
Eur J Neurol. 2000 Jul;7(4):449-53. doi: 10.1046/j.1468-1331.2000.00092.x.
Papillary fibroelastoma (PFE) is a rare benign tumour that attaches to the endocardial surface, mostly on cardiac valves. Though usually asymptomatic, it can be the source of several complications. To date, 49 cases have been reported of embolic stroke with a PFE as the probable origin.
(i) a 39-year-old male presented with ischemic embolic stroke; the presence of a PFE was assessed by means of transoesophageal echocardiography and confirmed by pathological findings; (ii) a 32-year-old woman presented with sudden onset of left hemiparesis; a cardiogenic embolic stroke was suspected, and a diagnosis of PFE was made based on echocardiographic and pathological findings. In both cases, surgical excision of the tumours was performed with no recurrences at follow-up. Two mechanisms can explain the formation of emboli in PFE: dislodgement of the tumour leaves or fibrin-platelet aggregation on the endocardial surface of these leaves. Transthoracic echocardiography may lead to the suspicion of a PFE, but transoesophageal echocardiography is required for confirmation. Prompt surgical excision is indicated in most cases. Anticoagulation is only recommended in situations of high surgical risk and during the wait for surgery.
乳头状纤维弹性瘤（PFE）是一种罕见的良性肿瘤，附着于心内膜表面，多数位于心脏瓣膜。虽然通常无症状，但它可能是多种并发症的来源。迄今为止，已有49例报告称以PFE为可能起源的栓塞性中风。
（i）一名39岁男性出现缺血性栓塞性中风；通过经食管超声心动图评估发现PFE，并经病理结果证实；（ii）一名32岁女性突然出现左侧偏瘫；怀疑为心源性栓塞性中风，根据超声心动图和病理结果诊断为PFE。在这两个病例中，均对肿瘤进行了手术切除，随访期间无复发。有两种机制可解释PFE中栓子的形成：肿瘤叶脱落或这些叶的心内膜表面上纤维蛋白 - 血小板聚集。经胸超声心动图可能会怀疑PFE，但需要经食管超声心动图来确诊。大多数情况下建议及时进行手术切除。仅在手术风险高的情况下以及等待手术期间推荐抗凝治疗。
