A tale of the unexpected: An abnormal left atrial mass

Abstract We present the case of a 64-year-old man who was incidentally found to have a left atrial mass in the vicinity of the left atrial appendage. Despite adequate anticoagulation for suspected thrombus for 6 months, the appearances of the mass remained unchanged. Surgical resection was recommended to reduce the risk of embolisation and to establish a histopathological diagnosis. Despite our initial suspicions of this being a myxoma the mass was ultimately confirmed to represent a rare papillary fibroelastoma occurring on the endocardial surface of the left atrium. The current report details the multimodality imaging of this phenomenon along with the diagnostic dilemma this unusual left atrial mass initially posed.