Introduction:
Primary aortic wall tumors are very rare and consist mainly of malignant tumors1. Papillary fibroelastomas (PFE) are benign neoformations usually originating from the valvular endocardium, consisting of non-vascularized papillary tissue surrounded by an endothelium line2. The localization of PFE on the aortic wall is extremely rare3,4. The clinical presentation of aortic PFE is usually related to embolization with myocardial infarction and/or stroke4,5. We report a case of aortic wall PFE simulating unstable angina, diagnosed with trans-thoracic and trans-esophageal echocardiography (TTE/TEE) and surgically removed.