Imaging of Mobile Emboligenic Calcified Amorphous Tumor in Mitral Annular Caseous Calcification.

Background: Caseous calcification of the mitral annulus (CCMA), a rare variant of mitral annular calcification, is occasionally associated with calcified amorphous tumors (CATs). These distinctive lesions are poorly documented, particularly regarding their potential for mobility and embolism.

Case Summary: A 73-year-old woman presented with acute left-sided hemiparesis and dysarthria. Serial echocardiography revealed CCMA-associated CAT with characteristic hypoechogenic appearance and peripheral calcification, demonstrating significant mobility with embolic events. The patient underwent urgent tumor resection, mitral valve replacement, and coronary artery bypass grafting, resulting in full recovery.

Discussion: This case uniquely captures the mobility and embolic risk of CCMA-associated CAT through serial imaging, including echocardiography. Appropriate modality selection and vigilant monitoring proved critical in guiding timely surgical intervention for this dynamically evolving cardiac mass.

Take-home Messages: CCMA-associated CATs may exhibit increased mobility and embolic potential, necessitating vigilant echocardiographic monitoring. Early surgical intervention could prevent embolic complications in these complex cardiac pathologies.