Pedunculated Endocardial Left Ventricular Fibroma Presenting With Cerebral and Bilateral Peripheral Embolization Ahmad K. Darwazah, FRCS, Jamal Shoeb,

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Pedunculated Endocardial Left Ventricular Fibroma Presenting With Cerebral and Bilateral Peripheral Embolization Ahmad K. Darwazah, FRCS, Jamal Shoeb, MD, Saad S. Eissa, MD The Annals of Thoracic Surgery Volume 89, Issue 3, Pages 965-967 (March 2010) DOI: 10.1016/j.athoracsur.2009.07.069 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Magnetic resonance imaging shows an acute right cerebral infarction. (B) Magnetic resonance angiography shows the right middle cerebral artery is patent but is shifted upwards and medially by the infarcted area (arrow). The Annals of Thoracic Surgery 2010 89, 965-967DOI: (10.1016/j.athoracsur.2009.07.069) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Echocardiography shows a left ventricular (LV) mass attached to the interventricular septum and extending to middle left ventricular cavity. (LA = left atrium; RA = right atrium; RV = right ventricle). The Annals of Thoracic Surgery 2010 89, 965-967DOI: (10.1016/j.athoracsur.2009.07.069) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 The excised elongated left ventricular mass was attached by narrow stalk (arrow). The Annals of Thoracic Surgery 2010 89, 965-967DOI: (10.1016/j.athoracsur.2009.07.069) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Histopathology. Left photomicrograph shows proliferating fibroblasts and mature collagen by hematoxylin and eosin stain (×400). Right photomicrograph shows fibroblasts (positive blue stain) and cardiac muscle (red stain) by Masson trichrome (×100). The Annals of Thoracic Surgery 2010 89, 965-967DOI: (10.1016/j.athoracsur.2009.07.069) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions