Cardiac calcified amorphous tumor in the right atrium: a rare cardiac neoplasm

BACKGROUND: Cardiac calcified amorphous tumors (CATs) represent rare, nonneoplastic intraluminal heart masses, with limited case reports in existing literature. Asymptomatic cases localized in the right atrium are particularly unusual. CASE PRESENTATION: An asymptomatic 46-year-old male was discovered to have a cardiac mass upon echocardiograph. Echocardiography revealed a 13.2 × 11.8 mm pedunculated mass in the right atrium, attached to the interatrial septum. Then we performed surgical treatment. Histopathology revealed some myocardial tissue, a powdery stained, calcified amorphous area, and a few localized lymphocytes and red blood cells. The final diagnosis confirmed a cardiac CAT. CONCLUSIONS: CATs, rarely occurring endocardium-based pseudotumors, comprise calcium nodules and amorphous fibrin material. Typically presenting as a calcified pedunculated mass, they may arise in any heart chamber, with a significant propensity for distal embolism. Differentiating CATs from calcified atrial myxomas, calcified thrombi, or other cardiac tumors is challenging. Histopathology remains a critical diagnostic cornerstone. Although complete surgical resection is the recommended treatment, anticoagulation and ongoing surveillance may serve as viable alternatives when primary treatment, surgical resection, is deemed excessively hazardous.