Papillary fibroelastoma

A papillary fibroelastoma is a rare benign primary cardiac tumour. However of the primary cardiac tumours, they are one of the commonest to occur in relation to the cardiac valves.


Its estimated prevalence ranges between < 0.01 to 0.33 % 5.


Characterised by papillary growth of stromal tissue composed of a central dense amorphous fibrous core and an surrounding layer of loose connective tissue. There is a also a layer of elastic fibres (hallmark) which is variable in distribution. This is further surrounded by a single layer of hypertrophied endothelium.


~ 80% occur in relation to either the aortic of mitral valve 2 while tricuspid and pulmonary involvement is much rarer.

Radiographic features

Cardiac MRI

Typically seen as a small ( ~1.5 cm 5) well defined pedunculated mass in relation to a valve.

* T1 : intermediate intensity 1,2
* T2 : inter mediate to high intensity 1,2
* SSFP Cine : may be useful for showing mobility (often highly mobile)


  • systemic embolisation of tumour or thrombotic components 5


Surgical resection is the treatment of choice.

Article Author : Dr Yuranga Weerakkody, Radiopaedia


* 1 Markus Kondruweit, Papillary fibroelastoma of the mitral valve: appearance in 64-slice spiral computed tomography, magnetic resonance imaging, and echocardiography ; Eur Heart J (2007) doi: 10.1093/eurheartj/ehm475
* 2. Philip A. Araoz, CT and MR Imaging of Primary Cardiac Malignancies, November 1999 RadioGraphics, 19, 1421-1434.
* 3. David H. O'Donnell, Review : Cardiac Tumors: Optimal Cardiac MR Sequences and Spectrum of Imaging Appearances, AJR 2009; 193:377-387
* 4. Anil K. Attili1 and Felix S. Chew ;Imaging of Cardiac Masses and Myocardial Disease: Self-Assessment Module, AJR 2007; 188:S21-S25
* 5. Damodar Kumbala, “Perilous Pearl”—Papillary Fibroelastoma of Aortic Valve: A Case Report and Literature Review, ANGIOLOGY October 2008 vol. 59 no. 5 625-628

Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License