Transthoracic (a) and transesophageal echocardiography (b) imaging of a large pedunculated aortic valve mass (yellow arrows) subsequently identified as a papillary fibroelastoma (PFE). Cardiac-gated CT angiography (c) demonstrates the numerous papillary fronds (long arrow) emanating from the heavily calcified central stalk (short arrow). Following surgical resection, the mass was confirmed as a PFE by gross and histologic inspection (d) including Verhoeff-Van Gieson staining (e). Ao: aorta, LV: left ventricle.