Ischemic stroke in a young woman with aortic papillary fibroelastoma: echocardiographic diagnosis and surgical excision.

Papillary fibroelastoma is a benign cardiac tumor typically attached to the cardiac valves. The tumor is recognized during life often in patients evaluated for embolic events of unclear etiology, but sometimes it is recognized in totally asymptomatic patients. We describe the case of a papillary fibroelastoma involving the aortic valve in a 27-year-old woman who presented ischemic stroke. The diagnosis was obtained at two-dimensional echocardiography and confirmed at transesophageal echocardiography. The tumor was located in the non-coronary aortic cusp, without aortic regurgitation. No other embolic source was identified. The tumor was surgically removed. The resection was curative by complete surgical excision, without damage of the aortic valve. The biopsy confirmed the diagnosis. The clinical course was uneventful. This case is an example of a primary intracavitary tumor recognized in a young woman with unclear embolic event. Two-dimensional echocardiography proved to be the exam of choice for the early diagnosis of cardiac tumors.