title: Caseous calcification of the mitral annulus: a multi-modality imaging perspective.
abstract: Mitral annulus calcification is a common echocardiographic finding, particularly in the elderly and in end-stage renal disease patients under chronic dialysis. Caseous calcification or liquefaction necrosis of mitral annulus calcification is a rare evolution of mitral annular calcification. Early recognition of this entity avoids an invasive diagnostic approach, since it is benign and, unlike intracardiac tumors and abscesses, has a favorable prognosis. The authors present the case of an 84-year-old woman with a suspicious large, echodense mass at the level of the posterior mitral leaflet with associated severe mitral regurgitation. Cardiac magnetic resonance imaging demonstrated a hypoperfused mass with strong peripheral enhancement 10 minutes after gadolinium administration. Multislice computed tomography showed the calcified nature of the mass. A multi-modality imaging approach confirmed the diagnosis of caseous calcification of the posterior mitral annulus. The patient refused surgical treatment.
authors.affiliation: Cardiology Department - Braga Hospital, Braga, Portugal. silviamartinsribeiro@gmail.com
authors.forename: Sílvia
authors.initials: S
authors.lastname: Ribeiro
authors.forename: Alberto
authors.initials: A
authors.lastname: Salgado
authors.forename: Nuno
authors.initials: N
authors.lastname: Salomé
authors.forename: Nuno
authors.initials: N
authors.lastname: Bettencourt
authors.forename: Pedro
authors.initials: P
authors.lastname: Azevedo
authors.forename: António
authors.initials: A
authors.lastname: Costeira
authors.forename: Adelino
authors.initials: A
authors.lastname: Correia
mesh_terms: D000369:Aged, 80 and over; D002114:Calcinosis / Q000175:diagnosis*; D005260:Female; D005740:Gases; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008943:Mitral Valve; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D005740:Gases