title: Caseous mitral annular calcifications: Multimodality imaging characteristics.
abstract: The authors report herein a series of 3 patients with caseous mitral annular calcifications (MAC). One of the patients presented with mass-like, caseous MAC as an incidental finding on a staging computed tomography (CT) for metastatic colorectal carcinoma. Another patient presented with a nodule on a chest radiograph, which was later found on CT to be due to caseous MAC. In the third patient, caseous MAC was initially detected on echocardiography, and was further evaluated with CT and cardiac magnetic resonance imaging. In all three patients, the appearances posed a diagnostic dilemma. The appearance of caseous MAC is dissimilar to non-caseous MAC and is usually seen as an ovoid, mass-like structure, with homogeneous hyperattenuation, representing a liquefied form of calcium and proteinaceous fluid. This homogeneous center is surrounded by peripheral, shell-like calcifications. Caseous MAC is likely an under-recognized entity and may present a diagnostic dilemma at CT, magnetic resonance imaging, or echocardiography.
authors.affiliation: Jabi Shriki, Partick M Colletti, Alison Wilcox, Department of Radiology, University of Southern California, Keck School of Medicine, Los Angeles, California, CA 90012, United States.
authors.forename: Jabi
authors.initials: J
authors.lastname: Shriki
authors.forename: Christine
authors.initials: C
authors.lastname: Rongey
authors.forename: Bobby
authors.initials: B
authors.lastname: Ghosh
authors.forename: Samuel
authors.initials: S
authors.lastname: Daneshvar
authors.forename: Partick M
authors.initials: PM
authors.lastname: Colletti
authors.forename: Ali
authors.initials: A
authors.lastname: Farvid
authors.forename: Alison
authors.initials: A
authors.lastname: Wilcox