{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:52:50Z","timestamp":1791449570637,"version":"4.3.3"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Papillary fibroelastoma, generally affecting the valve endocardium, is one of the most common benign cardiac tumours. Although rarely reported, atypical localization of such tumours complexifies diagnosis and might negatively impact patient outcomes due to late detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We present the case of a 69-year-old female patient presenting for a check-up consultation and reporting symptoms of dysesthesia, aphasia, and dizziness. The patient had a history of atrial fibrillation on anticoagulation with rivaroxaban starting 6 years prior to presentation. Further examination using transthoracic and transoesophageal echocardiography revealed a hyperechogenic structure at the level of the subvalvular apparatus of the mitral valve. Interestingly, when cardiac MRI was subsequently performed, this diagnosis could not be confirmed. This discrepancy might be linked to the lower spatial and temporal resolution compared to transoesophageal echocardiography, or transthoracic echocardiography with a high-frequency probe. To further investigate the symptoms of dysesthesia, aphasia, and dizziness, a cerebral MRI was performed which revealed multiple, bilateral ischaemic lesions. Considering the findings and the symptoms of the patient, the choice was made to perform explorative surgery. Intraoperatively, an 8-mm structure was identified and removed from the basis of the posteromedian papillary muscle. Histological examination revealed a papillary fibroelastoma. The patient was discharged on postoperative day 10. At follow-up, there was no report of neurological symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case shows a highly atypical localization of a rare cardiac tumour and exemplifies the importance of multimodal diagnostic imaging prior to cardiac surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf529","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T11:58:57Z","timestamp":1760183937000},"source":"Crossref","is-referenced-by-count":1,"title":["Papillary fibroelastoma of the papillary muscle\u2014a case report on a rare entity and sometimes a delayed diagnosis"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1715-0593","authenticated-orcid":false,"given":"Jules","family":"Miazza","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Basel , Petersgraben 4, 4031 Basel ,","place":["Switzerland"]},{"name":"Department of Cardiac Surgery, Inselspital Bern, University Hospital Bern , Freiburgstrasse 20, 3010 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1386-0686","authenticated-orcid":false,"given":"Oliver","family":"Reuthebuch","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Basel , Petersgraben 4, 4031 Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7881-6822","authenticated-orcid":false,"given":"Thierry","family":"Carrel","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Basel , Petersgraben 4, 4031 Basel ,","place":["Switzerland"]},{"name":"CardioBern AG, Lindenhofspital , Bremgartenstrasse 117, 3001 Bern ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"2025103005215883200_ytaf529-B1","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/S0002-8703(03)00249-7","article-title":"Cardiac papillary fibroelastoma: a comprehensive analysis of 725 cases","volume":"146","author":"Gowda","year":"2003","journal-title":"Am Heart J"},{"key":"2025103005215883200_ytaf529-B2","doi-asserted-by":"crossref","first-page":"4321","DOI":"10.1093\/eurheartj\/ehac244","article-title":"2022 ESC guidelines on cardio-oncology developed in collaboration with the European hematology association (EHA), the European society for therapeutic radiology and oncology (ESTRO) and the international cardio-oncology society (IC-OS)","volume":"43","author":"Lyon","year":"2022","journal-title":"Eur Heart J"},{"key":"2025103005215883200_ytaf529-B3","first-page":"123","article-title":"Case report papillary fibroelastoma of a mitral valve chordae, presenting with atypical chest pain and palpitation: a case report and the literature","volume":"5","author":"Ziabakhsh","year":"2014","journal-title":"Caspian J Intern Med"},{"key":"2025103005215883200_ytaf529-B4","doi-asserted-by":"crossref","DOI":"10.11604\/pamj-cm.2023.13.16.41505","article-title":"A fluttering papillary fibroelastoma in an atypical location: a case report","volume":"13","author":"Belharty","year":"2023","journal-title":"PAMJ Clinical Medicine"},{"key":"2025103005215883200_ytaf529-B5","first-page":"63","article-title":"Papillary fibroelastoma presenting as left ventricular mass: current update and literature review","volume":"33","author":"Kurian","year":"2006","journal-title":"Tex Heart Inst J"},{"key":"2025103005215883200_ytaf529-B6","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/S1010-7940(98)00006-2","article-title":"Cardiac papillary fibroelastoma of the mitral valve chordae","volume":"13","author":"Pacini","year":"1998","journal-title":"Eur J Cardiothorac Surg"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf529\/64697768\/ytaf529.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/10\/ytaf529\/64697768\/ytaf529.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/10\/ytaf529\/64697768\/ytaf529.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T09:22:09Z","timestamp":1761816129000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf529\/8285382"}},"subtitle":[],"editor":[{"given":"Cristiano","family":"Spadaccio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Mihai","family":"Strachinaru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Edgar","family":"Ram\u00edrez-V\u00e1zquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Jean-Luc","family":"Maigrot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Giorgia","family":"Benzoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":6,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf529","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,10,1]]},"article-number":"ytaf529"}}