Papillary fibroelastoma in an unusual location: arising from the left atrial endocardium.

Papillary fibroelastoma (PFE) is a rare, benign cardiac tumor, often asymptomatic and typically arising from the valvular endocardium. While predominantly located on the heart valves, involvement of the atrial chamber is exceptionally uncommon. This case report presents a 34-year-old female with a history of ischemic stroke, in whom a left atrial mass was subsequently identified. Notably, the tumor was attached to the left atrial endocardium near the left atrial appendage orifice and the anterior mitral leaflet, an unusual location for PFE that made diagnosis difficult. Initially suspected to be a myxoma, the lesion was definitively diagnosed as a papillary fibroelastoma following histopathological examination. This case underscores the importance of advanced imaging techniques, meticulous preoperative evaluation, and histological confirmation in diagnosing and managing cardiac tumors in unusual locations.