Key result
Caseous mitral annular necrosis presents as a pseudotumor linked to cardioembolic stroke manageable with anticoagulation.
Case Report (n=1)
Caseous necrosis of the mitral annulus should be considered as a potential rare cardioembolic source in patients presenting with stroke.
May prompt inclusion of caseous necrosis in mitral mass differentials for stroke; hypothesis-generating for anticoagulation.
The current report describes a rare case of a caseous necrosis presenting as a pseudotumor in ventricle, revealed by stroke. Cerebral MRI, showing multiples lacunes, evocates a cardioembolic mechanism. Transthoracic and transesophageal echocardiography demonstrate a large hyperechogenic mass fixed to the posterior mitral valve and annulus while thoracic tomography revealed a fully calcified lesion, at the mitral annulus, evocative of caseus necrosis. Medical therapy was preferred (anticoagulation), because of her age and the decaying nature of surgery.
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Corré et al. (2013) conducted a case report in Caseous necrosis of mitral annulus presenting with stroke (n=1). Medical therapy (anticoagulation) was evaluated. Caseous necrosis of the mitral annulus can present as a pseudotumor and cause cardioembolic stroke, which was managed with anticoagulation in this patient.