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Papillary fibroelastoma is the third most common primary tumor of the heart and is most likely to involve the cardiac valves. Like myxomas, they arise from the endocardium in most patients and since these tumors are often incidental findings at echocardiography or autopsy, the true incidence is difficult to estimate. Most patients are older than 60 years, which also contrasts with myxomas. Papillary fibroelastomas can embolize, leading to severe neurological complications and therefore, surgical removal is advised, although there is controversy regarding small incidental lesions and the need for surgery.
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