CTICasesRight Ventricular Outflow Tract Papillary Fibroelastoma
Imaging findings
Contrast-enhanced CT and cardiac MRI demonstrate a large, lobulated mass within the right ventricular outflow tract, separate from the pulmonary valve leaflets and arising from the free wall endocardium of the right ventricle, causing partial obstruction of flow across the valve. The mass shows heterogeneous, late gadolinium enhancement on MRI.
Key takeaways
Papillary fibroelastomas are benign cardiac tumors that typically arise from the cardiac valves, most commonly the aortic or mitral valves. However, they can rarely arise from the non-valvular endocardium, such as the right ventricular free wall or outflow tract. When presenting as a large, non-valvular mass, they can mimic cardiac myxomas or other primary cardiac tumors, but histological examination remains diagnostic, demonstrating characteristic branching avascular papillary fronds lined by single-layered endothelium.
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