Pathological evidence of cardiac papillary fibroelastoma in a retrieved intracranial embolus.

Approximately one-quarter of all cardiac tumors present with systemic embolization. Cardiac papillary fibroelastomas (CPF) represent a potential embolic source, accounting for 8% of all primary cardiac tumors, second in frequency after cardiac myxomas. Most case reports describe papillary fibroelastoma as a potential source for stroke, but histopathological evidence of actual tumor fragment causing a stroke is lacking. We describe a case of histologically confirmed CPF mechanically retrieved from a cerebral artery during an emergent cerebral endovascular procedure with subsequent discovery of the CPF in the heart, providing in vivo demonstration of intracranial embolization of this cardiac tumor.