Key result
Two cases of massive mitral annular calcification mimicking left atrial neoplasms were successfully diagnosed by CT scanning and managed conservatively with medical therapy.
Case Report (n=2)
Massive mitral annular calcification with caseous degeneration can mimic left atrial neoplasms on echocardiography, but can be accurately diagnosed with CT imaging.
CT may distinguish caseous mitral annular calcification from neoplasm and support conservative care; leaves open generalizability beyond case reports.
The authors describe two cases of massive mitral annular calcification, initially picked up on echocardiography and suspected of being neoplastic. Subsequent evaluation by CT scanning confirmed the location, aetiology, structure and diagnosis. Both cases demonstrated large masses, with calcification of varying density. This is likely explained by the presence of the previously reported amorphous caseous material demonstrated to be present within such mass structures. Such a feature is described as caseous degeneration. Both patients described have been managed conservatively with medical therapy, predominantly due to their age and general frailty.
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Dubrey et al. (2011) conducted a case report in Massive mitral annular calcification (n=2). Conservative medical therapy was evaluated. Two cases of massive mitral annular calcification mimicking left atrial neoplasms were successfully diagnosed by CT scanning and managed conservatively with medical therapy.
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