Mesothelial/monocytic incidental cardiac excrescence mimicking cardiac tumor

Mesothelial incidental cardiac excrescence is a non-neoplastic tumor-like lesion commonly occurring in the intracardiac region. The exact etiology is unclear. A 32-year-old woman presented with respiratory distress on exertion. Echocardiography showed severe aortic, mitral, and tricuspid regurgitation, for which triple-valve replacement was performed. A small cardiac excrescence was found over the aortic valve, measuring 0.6 × 0.3 × 0.3-cm, which on microscopy showed features of mesothelial/monocytic incidental cardiac excrescence. This condition is very rare but it must be recognized because it mimics a metastatic malignancy.