| Summary: | •The papillary fibroelastoma is a rare and benign primary cardiac tumor, and the mostly frequently found tumor occurring in cardiac valves.•When clinical conditions support the presence of infection, the papillary fibroelastoma may be misdiagnosed as a vegetation due to endocarditis.•The differential diagnosis of PFE includes other cardiac tumors, thrombus, vegetation, and Lambl’s excrescences.•Careful echocardiographic analyses during evaluation of valvular masses are strongly recommended for differential diagnosis.•Immediate surgical removal and valve repair or replacement are the procedure of choice.
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