Key result
Resection of a tumor-mimicking cardiac mass in a hemodialysis patient reveals severe mitral annular calcification.
Case Report (n=1)
Severe mitral annular calcification can mimic an intracardiac tumor in patients on long-term hemodialysis, potentially prompting early surgical intervention.
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May prompt inclusion of mitral annular calcification in differentials for calcified masses in hemodialysis patients; case report leaves open optimal noninvasive diagnosis.
Although mitral annular calcification (MAC) is usually easy to diagnose by transthoracic echocardiography, we experienced a rare case with MAC which looked like an intracardiac tumor. The patient who had been on chronic hemodialysis for 20 years was admitted to our hospital because of dyspnea. Transthoracic echocardiography showed a mass with severe calcification on the anterior mitral annulus and mean mitral gradient of 20 mm Hg. Because of the suspicion of the intracardiac calcified tumor that restricted mitral valve motion causing mitral obstruction, she underwent resection of the mass and mitral valve replacement. Pathological findings showed that the mass had a calcified envelope containing liquefied necrotic eosinophilic material with lympocytic infiltrate inside consistent with MAC. We should consider a possibility of MAC when we see a severe calcified mass attached to the mitral annulus in a patient on long-term hemodialysis.
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Kato et al. (2006) conducted a case report in Mitral annular calcification mimicking intracardiac tumor (n=1). Resection of the mass and mitral valve replacement was evaluated on Pathological diagnosis of the resected mass. Resection and pathological examination of a severe calcified mass mimicking an intracardiac tumor in a hemodialysis patient revealed it to be mitral annular calcification.
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