Abstract
Pulmonary valve myxomas are exceptionally rare cardiac tumors, with only a few reported cases in the literature, and their nonspecific presentation and uncommon location create diagnostic and surgical challenges. We report the case of a 68-year-old woman who presented with mild exertional dyspnea; transthoracic echocardiography demonstrated a 12 × 17 mm mobile mass prolapsing through the pulmonary valve, and cardiac magnetic resonance confirmed a pedunculated tumor attached to the ventricular surface of the left pulmonary cusp, without evidence of distal embolization. The patient underwent surgical excision with en bloc resection of the involved cusp and pericardial reconstruction, followed by an uneventful postoperative recovery, and histopathological analysis confirmed the diagnosis of myxoma. Pulmonary valve myxomas may manifest with obstructive, embolic, or constitutional symptoms, with dyspnea from right ventricular outflow tract obstruction representing the most frequent clinical presentation; diagnosis relies heavily on multimodality imaging, and complete surgical excision remains the definitive treatment. This case highlights the extreme rarity of pulmonary valve myxomas and underscores the value of comprehensive imaging assessment and meticulous surgical technique to achieve full tumor resection and favorable clinical outcomes.