Great Aortic Valve Disappointment when Fibroelastoma Mimics Infective Endocarditis

Certain tumors are specific to the heart, or have certain characteristics when they develop in the heart, notably myxoma and papillary fibroelastoma. Papillary fibroelastoma is a very rare benign cardiac tumor of preferential valvular localization. The aortic valve (AV) is most frequently affected. Patients are generally asymptomatic, although they are at high risk of cardiac and systemic embolic events. The systematic use of echocardiography has increased the detection of these tumors. Surgical excision remains the gold-standard treatment, with low operative risk and cure of symptoms. We report the case of a patient in whom infective endocarditis was strongly suspected based on clinical and echocardiographic findings. However, further investigation and surgical pathology revealed a papillary fibroelastoma masquerading as endocarditis. This case highlights the diagnostic challenges in differentiating between these two entities and underscores the importance of histological confirmation.