Spinal cord infarction in a woman with cardiac fibroelastoma.

A 61-year-old woman presented with the acute onset of right lower extremity paresthesias followed within 15 minutes by complete bilateral lower extremity paralysis and urinary incontinence. Magnetic resonance imaging of the thoracic spine, using a 1.5 Tesla magnetic resonance scanner with echo planar imaging technique, showed an intramedullary T2 hyperintense lesion that involved the central gray matter and portions of the white matter, extending from the T8 level to the conus medullaris. Diffusion weighted imaging of the spine showed restricted diffusion in an area corresponding to that of the T2 lesion. A transesophageal echocardiogram demonstrated a highly mobile oscillating mass attached to the left leaflet of the aortic valve, consistent with fibroelastoma. Fibroelastoma is an uncommon benign cardiac tumor that has been associated with cerebral embolic complications. It is our belief that this tumor and spinal cord infarction is exceedingly rare and only one such occurrence has been previously reported.