The left atrial myxoma that isn't: don't forget fibroelastomas

Primary cardiac tumours are rare; papillary fibroelastoma is one such example. Papillary fibroelastomas usually presents in elderly males as a small frond-like mass arising from native cardiac valves. We present an atypical case of a papillary fibroelastoma in a 46-year-old woman presenting with palpitations and a large 4.2 cm left atrial septal mass revealed on echocardiography. This case demonstrates that papillary fibroelastomas can be non-valvular and can grow to a large size, causing them to be mistaken for other tumours. It is therefore important to include papillary fibroelastomas in the differential diagnosis for a cardiac mass in the left atrial septum.