Miller Avraham, Perez Audrik, Pabba Swathi, Shetty Vijay
Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
Chalmeda Anand Rao Institute of Medical Sciences, Telangana, India.
Int Med Case Rep J. 2017 Mar 29;10:109-112. doi: 10.2147/IMCRJ.S119353. eCollection 2017.
Papillary fibroelastomas (PFEs) are the second most common benign neoplasms of the cardiac valves and are being recognized more frequently because of higher resolution imaging technology. PFEs are associated with substantial complications that are secondary to systemic embolism. Surgical resection should be offered to all patients who have symptoms and to asymptomatic patients who have pedunculated lesions or tumors larger than 1 cm in diameter. Herein, we present a patient who presented for a second time in 2 months with stroke symptoms. During his first admission, a transthoracic echocardiogram was performed and he was sent home after resolution of his symptoms and a grossly negative workup. During his second admission, a transesophageal echocardiogram was performed and the PFE was found and later excised. While this discussion reviews the literature with regard to detection and management, it will hopefully serve as a reminder to keep this on the differential when the workup has remained without an obvious source.
乳头状纤维弹性瘤（PFEs）是心脏瓣膜第二常见的良性肿瘤，由于高分辨率成像技术的应用，其被发现的频率越来越高。PFEs与继发于系统性栓塞的严重并发症相关。对于所有有症状的患者以及有带蒂病变或直径大于1cm肿瘤的无症状患者，均应进行手术切除。在此，我们报告一名患者，他在2个月内第二次因中风症状前来就诊。在他首次入院期间，进行了经胸超声心动图检查，症状缓解且检查结果大致正常后他出院回家。在他第二次入院期间，进行了经食管超声心动图检查，发现了PFE，随后将其切除。虽然本讨论回顾了有关检测和管理的文献，但希望能提醒大家，在检查未发现明显病因时，要将此病纳入鉴别诊断。
