Cardiac calcified amorphous tumor: A systematic review of the literature

Abstract

BackgroundCalcified amorphous tumor (CAT) of the heart is a rare non-neoplastic intracavitary cardiac mass. Several case reports have been published but large series are lacking.ObjectiveTo determine clinical features, current management and outcomes of this rare disease.DesignA systematic review of all articles reporting cases of CAT in order to perform a pooled analysis of its clinical features, management and outcomes.Data sourcesAn electronic search of all English articles using PUBMED was performed. Further studies were identified by cross-referencing from relevant papers.Inclusion criteriaWe restricted inclusion to articles reporting cases of CAT in the English language literature published up to July 2014.Data extractionOne author performed data extraction using predefined data fields.ResultsA total of 27 articles, reporting 42 cases of CAT were found and included in this review.ConclusionIn this review, the most frequent presenting symptoms were dyspnea and embolic events. Mitral valve and annulus were the most frequent location of CAT. Surgery was most of the time required to confirm diagnosis, and was relatively safe. Overall outcome after surgical resection was good.

Cardiac calcified amorphous tumors: CT and MRI findings

“…CATs can have a mobile appearance or an immobile one (firmly attached to the ventricle) on gradient-echo cine sequences. Configuration and shapes of cardiac CATs are variable in all published cases and in our study (14). Our results suggest that mass shapes, such as ovoid, irregular, tubular, triangular, and spherical, are nonspecific features for CAT.…”

“…De Hemptine et al (14) reported a literature review of 27 articles with 42 cases to provide more insight into the clinical characteristics of this disease. However, these studies did not report the imaging features of CAT.…”

A Case of Calcified Amorphous Tumor Found with Cerebral Infarction

“…It is thought that denatured serum components were accompanied by calcification with the background of chronic inflammatory changes [1]. Hemptinne and his colleagues reported the clinical features about 42 patients with CAT retrospectively, which said that the mean size of the tumor was 29 × 17 mm, and 36% of CAT occurred in the mitral valve or its annulus, 21% in the right atrium, 17% in the right ventricle [2]. 31% of CAT had valvular disease, 21% had end stage renal failure, 14% had diabetes, and 12% had coronary artery disease as complications.…”

“…31% of CAT had valvular disease, 21% had end stage renal failure, 14% had diabetes, and 12% had coronary artery disease as complications. Particularly, patients with CAT developed with the mitral valve annular calcification (MAC) have reported to be closely related to the end stage renal disease with maintenance dialysis [2][3][4][5].…”

“…CAT has been reported to be found unexpectedly by echocardiography performed for detecting the cause of cerebral infarction or heart failure, and to be likely to coexist with end-stage kidney disease [2]. Clinically it is necessary to differentiate from vegetation in infective endocarditis and cardiac tumors, and pathological diagnosis is necessary for definitive diagnosis, so most of it is surgically removed.…”