Unusual Location for a Large Cardiac Fibroma

A 37-year-old woman with palpitations and chest discomfort was referred to our institution for assessment of a right ventricular (RV) mass seen on echocardiography (Figure 1). Cardiovascular magnetic resonance confirmed the presence of a large oval mass (6×7 cm) within the basal RV free wall (online-only Data Supplement Movies I and II). The mass was causing compression of the RV inlet but no invasion of the tricuspid annulus or valve (Figure 2). The mass had a low signal on T1- and T2-weighted images, no increase in signal during first-pass perfusion, but diffuse delayed hyperenhancement after gadolinium injection, with some central areas of relatively low signal (Figure 2, B through D). These features are typical of cardiac fibroma. On surgery, a large, lobulated solid mass was excised from the …