Calcified Amorphous Tumor Causing Shower Embolism to the Brain: A Case Report with Serial Echocardiographic and Neuroradiologic Images and a Review of the Literature.
An 89-year-old woman with chronic atrial fibrillation, hypertension, chronic heart failure, and dementia was admitted to our hospital due to multiple small cerebral and cerebellar infarctions. Transthoracic echocardiogram revealed a floating calcified mass lesion arising from the endocardium of the posterior portion of the mitral annulus with mitral annular calcification. Furthermore, the mass had a heterogeneity of the echogenicity. The mass was diagnosed as a calcified amorphous tumor based on specific echocardiographic features. Serial echocardiograms showed shrinkage and disappearance of the mass, and magnetic resonance image revealed new infarction in the left occipital lobe. Embolization of the mass appeared to cause systemic embolism.
Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan. Electronic address: takaomi.sing@gmail.com.
Takaomi
T
Singu
Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
Yuichiro
Y
Inatomi
Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
Toshiro
T
Yonehara
Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Yukio
Y
Ando
D000369:Aged, 80 and over; D020520:Brain Infarction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D017548:Echocardiography, Transesophageal; D005260:Female; D006338:Heart Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed
Embolic stroke; calcified amorphous tumor; mitral annular calcification; shower emboli