Caseous Calcification: Now You See Me, Now You Don't

Area of Science:

• Cardiology
• Cardiac Imaging

Background:

• Mitral annulus calcification (MAC) can present as a rare variant called caseous calcification.
• This condition can mimic other cardiac masses like infective endocarditis or myxoma.

Observation:

• Transthoracic echocardiography reveals CCMA as a large, echodense mass with calcification and central lucency.
• A case is presented of a 72-year-old female with comorbidities undergoing evaluation for kidney transplantation.
• CCMA was identified on echocardiography attached to the posterior mitral valve.

Findings:

• The observed cardiac mass, identified as CCMA, spontaneously resolved prior to planned mitral valve surgery.
• This spontaneous resolution highlights the typically benign nature of CCMA.
• Accurate echocardiographic identification is crucial for appropriate patient management.

Implications:

• CCMA should be included in the differential diagnosis for cardiac masses, especially those on the posterior mitral valve.
• Distinguishing CCMA from other cardiac pathologies prevents unnecessary invasive procedures.
• Understanding the benign and self-limiting course of CCMA improves patient outcomes and reduces healthcare costs.