Case Report: Multimodality imaging of a primary right ventricular fibroma in an asymptomatic adult

Cardiac fibromas are rare primary benign tumors, predominantly occurring in children; their presentation in asymptomatic adults is uncommon. We report the case of a 23-year-old male with a right ventricular (RV) mass incidentally detected during a routine echocardiographic screening. The mass was characterized using multimodality imaging. Coronary CT angiography (CCTA) delineated its intramural location and identified anatomical relationship with the right coronary artery. Cardiovascular magnetic resonance (CMR) showed uniform T1 and T2 hypointensity alongside intense, homogeneous late gadolinium enhancement, findings characteristic of a dense collagenous matrix. The patient was referred to a specialized center for definitive management, where the tumor was successfully excised. Postoperative histopathology confirmed the diagnosis of a cardiac fibroma. This case demonstrates that integrating CCTA and CMR provides valuable non-invasive characterization differentiating rare cardiac masses and assists in pre-operative planning to mitigate the long-term risk of adverse cardiac events.