Caseous Calcification of the Mitral Annulus

Abstract

Soft-tissue masses or mass-like lesions involving the mitral valve include a wide range of diseases such as tumors, abscesses, vegetations, thrombus and, rarely, caseous calcifications of the mitral annulus. Caseous calcifications of the mitral annulus is a rare variant of mitral annular calcification that is usually asymptomatic and diagnosed incidentally. Echocardiography is the first-choice imaging modality. Cardiac computed tomography is an ideal tool to confirm the presence of calcifications and caseous necrosis. In cases where there is doubt, cardiac magnetic resonance imaging may be used. We present the case of a 62-year-old patient with an intra-cardiac mass diagnosed by echocardiography. Imaging modalities to achieve a correct diagnosis and avoid unnecessary surgical intervention are discussed.

Chameleonic appearance of caseous calcification of the mitral valve – still a problem for its appropriate management

“…And surgical treatment may not be needed when there is no obstruction. This entity is diagnosed on cardiac MRI, multi-modality imaging, especially non-contrast computed tomography (CT), and allows for the confident and prospective diagnosis [11,12].…”

Multimodality Imaging of Cardiac Myxomas

“…On MRI, it has a low signal on T1-and T2-weighted images and cine SSFP imaging, without enhancement during firstpass perfusion imaging. Peripheral LGE of the mass can be observed [41]. Other benign neoplastic cardiac masses that can mimic a myxoma include cardiac lipoma and hemangioma.…”

“…On MRI, it has a low signal on T1- and T2-weighted images and cine SSFP imaging, without enhancement during first-pass perfusion imaging. Peripheral LGE of the mass can be observed [ 41 ].…”