To highlight the imaging characteristics of cardiac papillary fibroelastomas and to illustrate cases of lesions located in different sites. To discuss and to exemplify the differential diagnosis. To emphasise the importance of an early and accurate diagnosis, because of the serious complications that can occur.

Epidemiology rare benign primary cardiac tumor the most common tumor of the valves the second most common cardiac benign tumor, following myxomas [1,2] all age groups, most frequently between the 4th and the 8th decade of life [1-3] equal gender prevalence [1,2], although some studies found either a slight male [3] or female [4,5] predilection usually a solitary tumor, may be multiple [6] Location endocardium typically cardiac valves, especially in the left heart, aortic valve the most frequently affected [1-3,7] non-valvular sites of origin: left...

Imaging findings Echocardiography (initially transthoracic, usually followed by transesophageal) small, well-defined, usually pediculated mass attached to the valves or the endocardium high mobility, may prolapse into the cardiac chambers during the cardiac cycle “speckled” appearance with “stippling” near the edges, corresponding to the papillary fronds [1-3,9,11,12] Computed tomography (CT) small, hypodense mass, with irregular margins and a thin stalk cine ECG gated imaging: mobility [3,13,14] Magnetic resonance imaging (MRI) small, round, homogeneous, pediculated mass attached to the valves or to the endocardium isointense on T1,...

While being a relatively rare benign cardiac tumour,papillary fibroelastoma can lead to major complications and therefore it is important to diagnose it correctly as soon as possible, in order to establish the appropriate treatment.

Contact details: Dr. Andra Perja, 4th year radiology resident, Radiology Department, County Clinical Emergency Hospital, Cluj-Napoca/Romania Email: [email protected] A. Perja; Cluj/RO - nothing to disclose R. Rancea; Cluj/RO - nothing to disclose S. Encică; Cluj/RO - nothing to disclose A. Molnar; Cluj/RO - nothing to disclose S. Manole; Cluj/RO - nothing to disclose

1. Araoz PA, Mulvagh SL, Tazelar HD et al. CT & MR imaging of benign cardiac neoplasms correlated with echocardiographic correlation. Radiographics. 2000;20:1303–19. 2. Mariscalco G, Bruno VD, Borsani P, Dominici C, Sala A. Papillary fibroelastoma: Insight to a primary cardiac valve tumor. J Card Surg. 2010;25(2):198–205. 3. Gowda RM, Khan IA, Nair CK, Mehta NJ, Vasavada BC, Sacchi TJ. Cardiac papillary fibroelastoma: A comprehensive analysis of 725 cases. Am Heart J. 2003;146(3):404–10. 4. Ikegami H, Andrei AC, Li Z, McCarthy PM, Malaisrie SC. Papillary...