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We present the case of a healthy, asymptomatic 50-year-old woman with a systolic ejection murmur who was found to have an obstructive left ventricular outflow tract mass. Transthoracic echocardiography revealed a large mobile mass attached to the basal anterior septum of the left ventricle. Surgical resection was performed and a benign left ventricular outflow tract myxoma was diagnosed. The patient's postoperative course was unremarkable. We describe the clinical presentation and role of 2- and 3-dimensional transthoracic and transesophageal echocardiography in surgical management.

Lipomatous lesions of the heart and cystic tumor of the atrioventricular node are not common. A pathologist will only rarely encounter these entities, and in the case of the atrioventricular node tumor, only if they examine the conduction system. Most fatty lesions are not clinically significant; however, arrhythmias, blood flow obstruction, and valvular dysfunction may result from benign or malignant lipomatous tumors. Cystic tumor of the atrioventricular node has been implicated in the causation of sudden cardiac death, and there has been much academic interest concerning its cell of origin.

The routine use of echocardiography has led to an increase in the diagnosis of cardiac papillary fibroelastomas. From 1990 to 2004, 10 cases of papillary fibroelastoma were observed, nine of which underwent successful surgical excision with valve repair or replacement and without major complications. One patient presented with an asynchronous lesion requiring repeat excision. Surgical excision of papillary fibroelastomas is safe and curative, and carries minimal morbidity. A review of the current literature suggests that symptomatic cardiac papillary fibroelastomas should be surgically removed, whereas asymptomatic lesions that are left-sided, large (larger than 1 cm) or mobile should be considered for surgical excision.

Lipomatous lesions of the heart involving the atria and interatrial septum are not well known. Most such lesions do not become clinically significant; however, intractable arrhythmias, blood flow obstruction, and valvular disruption may result from extensive fatty infiltration of the atrial wall or from the mass effect of benign or malignant lipomatous tumors. Some fatty lesions may be difficult to characterize radiologically, and misdiagnosis may lead to unnecessary surgical interventions. We describe the pathology of the most common fatty lesions and underscore some of the radiographic and surgical issues pertaining to the diagnosis and management of these masses.

There is a lack of information regarding the diagnosis and management of papillary fibroelastoma of the pulmonary valve due to the rarity of the tumour at this location. A case of pulmonary valve papillary fibroelastoma in a 60-year-old woman is reported and the approach for diagnosis and management is described.

Papillary fibroelastomas are rare, benign cardiac tumours that most commonly arise from cardiac valves, and often present with signs and symptoms of embolization. A patient presented initially with transient ischemic attacks. He was found to have a papillary fibroelastoma on his tricuspid valve, which was successfully resected. Nine years later, he presented again with cerebral embolic symptoms and was found to have a new fibroelastoma on his mitral valve. The presence of a new lesion should be considered if signs or symptoms recur.