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Background Papillary Fibroelastomas are uncommon primary cardiac tumors and their recurrence after resection is rare. Case Summary A 32-year-old woman, who was evaluated for recurrent embolic stroke, was found to have lesions on mitral leaflets on echocardiography. The mitral leaflets were otherwise normal with no clinical or laboratory evidence of infective endocarditis. Transthoracic, as well as transesophageal echocardiography, revealed masses on mitral leaflets, which remained almost the same over 3 years. A tentative diagnosis of papillary fibroelastoma on the mitral valve was made. She had intra-cardiac mass excision with mitral annuloplasty in February 2020. In November 2021, during her regular follow-up visit, transthoracic echocardiography revealed the recurrence of the masses on mitral leaflets with severe mitral regurgitation. She underwent mitral valve replacement and excision of tumor masses. Histopathological examination confirmed the diagnosis of recurrent papillary fibroelastoma. Discussion Recurrence of papillary fibroelastomas is rare. We report a rare case of histologically proven recurrence of Papillary Fibroelastoma of the mitral valve. This highlights the importance of routine post-operative echocardiographic follow-up of patients with papillary fibroelastoma.
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