CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 1, January – April 2024 AFRICA 65 Histopathological examination showed that the mass was a fibroma, which presented as a tumour-like hyperplasia of the fibrous tissue with abundant collagen fibres. There was no evidence of mitotic figures or malignancy (Fig. 3). Fig. 2. Intra-operative findings. (A) The mass was on the anterior wall of the right ventricle and received its blood supply from the distal portion of the left anterior descending artery. (B) The mass had a smooth, yellowish surface and measured 3 × 3 × 2 cm. Fig. 3. Pathological examination of the resected tissue (with haematoxylin–eosin staining). The specimen was found to contain hyperplastic fibrous tissue with abundant collagen fibres and a calcified component with scattered inflammatory cells infiltrating the tissue. Fig. 1. Findings on pre-operative imaging. (A) Transthoracic echocardiography showed a 4.3 × 0.7-cm area of calcification within the myocardium on the anterior wall of the right ventricle near the apex at the subcostal window. (B) Cardiac computed tomography revealed a calcified pericardial mass in the apical area that extended to the anterior free wall of the right ventricle. (C) Coronary angiography showed normal coronary arteries but a calcified pericardial mass at the distal portion of the left anterior descending artery as an incidental finding. (D) Transoesophageal echocardiography identified a calcified mass measuring 3 × 2 cm in the apical interventricular groove that extended to the anterior wall of the right ventricle at the middle of the oesophageal view of 123°. A A B C B D
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