CTICasesPapillary Fibroelastoma of the Aortic Valve
Imaging findings
A long-standing, previously followed lesion on the aortic valve appears as a hypoattenuating mass attached to a leaflet, frond-like in morphology, without associated valve thickening or destruction.
Key takeaways
The differential for a small mobile mass on an otherwise normal-appearing valve is essentially vegetation versus papillary fibroelastoma versus, less likely, myxoma; an intact, non-destroyed valve argues against endocarditis, which characteristically thickens and disfigures the valve. Surgical excision confirmed papillary fibroelastoma, and the patient was fortunate not to have embolized despite the lesion being present for years.
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