A rare pediatric cardiac papillary fibroelastoma: a case report

Cardiac papillary fibroelastoma (PFE) is rare in children, and large (>30 mm), mobile, right-sided PFEs are exceptionally uncommon. This report describes a 7-year-and-6-month-old patient who presented with upper respiratory tract infection and an incidental cardiac murmur. Transthoracic echocardiography revealed a 30 × 25 × 21 mm pedunculated, mobile mass on the anterior tricuspid valve leaflet. Differential diagnosis included thrombus, vegetation, and other cardiac tumors. Surgical excision with tricuspid valvuloplasty was performed due to embolization risk. Gross examination showed a cauliflower-like mass. The patient recovered uneventfully with preserved valve function. This case demonstrates that large, mobile right-sided PFEs can occur in asymptomatic children, and early surgical intervention with valve preservation is recommended to prevent embolic complications.