Prophylactic resection of an incidental right ventricular fibroma in a child

Cardiac fibromas are rare benign tumors in children that may present incidentally. We report a 4-year-old asymptomatic boy with a right ventricular fibroma detected during routine examination. Multimodality imaging including echocardiography and cardiac computed tomography demonstrated a 24.5 × 33.6 mm well-circumscribed mass beneath the right ventricular outflow tract without hemodynamic compromise. Despite the absence of symptoms, prophylactic complete resection was performed given the tumor's non-regressive nature and potential arrhythmogenic risk. Histopathology confirmed cardiac fibroma. The patient remained recurrence-free with normal ventricular function at 8-year follow-up. This case highlights the role of early surgical intervention in pediatric cardiac fibromas, even in asymptomatic patients, to prevent future life-threatening complications.