{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T19:51:30Z","timestamp":1774468290662,"version":"3.50.1"},"reference-count":35,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground<\/jats:title>\nPapillary fibroelastoma (PFE) and myxoma are relatively common types of benign cardiac tumors. PFE and myxoma can be associated with fatal embolic events. However, PFE is not widely recognized within the field of cerebrovascular diseases.<\/jats:p>\n<\/jats:sec>\n\nCase Description<\/jats:title>\nA 54-year-old male presented with a sudden onset of left hemiparesis. Three-dimensional computed tomography (CT) angiography revealed incomplete occlusion of the right middle cerebral artery. Thrombolytic therapy with recombinant tissue-type plasminogen activator was performed, followed by mechanical thrombectomy. Reperfusion was achieved within 199 minutes, resulting in thrombolysis in cerebral infarction grade 2b. The retrieved emboli appeared as a white gelatinous substance, which was diagnosed as PFE by histopathological examination. Transesophageal echocardiography and cardiac CT identified a 6-mm mobile mass in the left atrium. PFE in the left atrium was considered to be the source of the embolism and tumor resection was performed on day 18. Histopathological findings of the resected tumor were identical to those of the emboli. The patient was transferred to a rehabilitation facility on day 36, with a modified Rankin Scale score of 2.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nPFE and myxoma share many clinical features, but PFE tends to be smaller, so detection is more challenging and has likely resulted in under-recognition. PFE and myxoma can be associated with fatal embolic events. Resection is recommended for left-sided, mobile, symptomatic tumors larger than 10 mm. The differential diagnosis of embolus retrieved through mechanical thrombectomy should consider both myxoma and PFE and persistent efforts should be made to detect the embolic origin.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_68_2025","type":"journal-article","created":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T07:40:02Z","timestamp":1744962002000},"page":"141","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mechanical thrombectomy for cerebral embolism due to cardiac papillary fibroelastoma: A case report"],"prefix":"10.25259","volume":"16","author":[{"given":"Kentaro","family":"Izumi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Osaki Citizen Hospital, Osaki, Japan"},{"name":"Preemptive Medicine in the Community of the North Miyagi, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youhei","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Osaki Citizen Hospital, Osaki, Japan"},{"name":"Preemptive Medicine in the Community of the North Miyagi, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoya","family":"Iwabuchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Osaki Citizen Hospital, Osaki, Japan"},{"name":"Preemptive Medicine in the Community of the North Miyagi, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Osaki Citizen Hospital, Osaki, Japan"},{"name":"Preemptive Medicine in the Community of the North Miyagi, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuniyasu","family":"Niizuma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"},{"name":"Department of Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"},{"name":"Department of Neurosurgical Engineering, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenori","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,4,18]]},"reference":[{"key":"10.25259\/SNI_68_2025\/ref-1","first-page":"697","article-title":"Papillary fibroelastoma of the left ventricular outflow tract; report of a case","volume":"71","author":"Arai","year":"2018","journal-title":"Kyobu Geka"},{"key":"10.25259\/SNI_68_2025\/ref-2","doi-asserted-by":"crossref","first-page":"105352","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105352","article-title":"Tumor embolism through right-to-left shunt due to venous invasion of esophageal carcinoma","volume":"29","author":"Araki","year":"2020","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.25259\/SNI_68_2025\/ref-3","doi-asserted-by":"crossref","first-page":"e417","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.05.006","article-title":"Effective mechanical thrombectomy in a patient with hyperacute ischemic stroke associated with cardiac myxoma","volume":"23","author":"Baek","year":"2014","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.25259\/SNI_68_2025\/ref-4","doi-asserted-by":"crossref","first-page":"572","DOI":"10.3171\/2009.6.JNS09221","article-title":"Endovascular mechanical retrieval of a terminal internal carotid artery breast tumor embolus","volume":"112","author":"Bhatia","year":"2010","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_68_2025\/ref-5","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1001\/jama.1975.03240210031015","article-title":"Myocardial infarction without atherosclerosis","volume":"231","author":"Cheitlin","year":"1975","journal-title":"JAMA"},{"key":"10.25259\/SNI_68_2025\/ref-6","first-page":"36","article-title":"Surgical treatment of primary cardiac tumors: 20-year single center experience","volume":"19","author":"D\u011brgel","year":"2022","journal-title":"Kardiochir Torakochir Pol"},{"key":"10.25259\/SNI_68_2025\/ref-7","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1111\/his.12531","article-title":"The mysterious pathways of cardiac myxomas: A review of histogenesis, pathogenesis and pathology","volume":"66","author":"Di Vito","year":"2015","journal-title":"Histopathology"},{"key":"10.25259\/SNI_68_2025\/ref-8","first-page":"335","article-title":"Endocardial papillary elastofibromas. 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