An 80-year-old woman presented with dyspnoea. Laboratory test results and ECG were normal but echocardiography revealed a right atrial round mobile mass measuring about 20 mm. CT scan and cardiac MRI showed a mass appending on the right atrial free wall above the tricuspid annulus, enhanced by contrast, without any thoracic or abdominal extension, and confirmed the diagnosis of a tumour. After surgical treatment, the pathological examination revealed a cardiac papillary fibroelastoma. This small primary cardiac benign neoplasm usually occurs on cardiac valves, but can also appear, as described here, in a non-valvular localization. The diagnosis is, up to now, usually made by echocardiography, but CT and MR imaging could lead to a better description and analysis of this underestimated tumour.
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