Cardiac papillary fibroelastoma mimicking left ventricle apical thrombus

Papillary fibroelastomas (PFE) are one of the most common types of primary cardiac tumors. They are a potential cause of transient ischemic attacks (TIA), strokes, myocardial infarction, and sudden death. We report the case of a 64-year-old woman who suffered from a TIA 10 years previously and a stroke a few years later. Transthoracic echocardiography (TTE) revealed a mass compatible with a thrombus in the apex of the left ventricle. The rest of the etiological assessment was negative. Anticoagulation treatment was started along with a TTE and magnetic resonance imaging (MRI) follow up. The patient presented with a new ischemic stroke two months later, and MRI revealed an increase in mass. After multidisciplinary discussion, a surgical excision was performed, and the histological study revealed PFE. The postoperative course was uneventful, and the patient was discharged 10 days after surgery.