Calcified amorphous tumor presenting with rapid growth in the ascending aorta

Extracavitary Cardiac Calcific Amorphous Tumors Compressing Biventricular Outflow Tracts

Extracavitary cardiac calcific amorphous tumors/masses are extremely rare. We present a case report of a 62-year-old man with end-stage renal disease who presented with extracavitary cardiac calcific amorphous tumors/masses compressing the biventricular outflow tracts, resulting in hemodynamic compromise and progressive limitation of activities. The patient was successfully treated with surgery, with complete resolution of symptoms and markedly improved quality of life.

Cardiac calcified amorphous tumour: an unusual aetiology for recurrent cardioembolic strokes

We report an elderly woman with vascular risk factors and recurrent cardioembolic strokes in whom the stroke aetiology was finally ascertained to be a calcified amorphous tumour of the heart after repeated negative investigations for embolic aetiology over 2 years. This report discusses the clinical and imaging characteristics of calcified amorphous tumours of the heart with emphasis of recent advances in cardiac imaging.

Multiple cerebral infarctions due to calcified amorphous tumor growing rapidly from an antecedent infection and decreasing rapidly by detachment of fibrin and antithrombotic drugs: a case report

BACKGROUND

Calcified amorphous tumor (CAT) of the heart is a rare non-neoplastic intracardiac mass, a calcium deposition surrounded by amorphous fibrous tissue, and possibly causes cerebral embolism. Even rarer is CAT associated with infection, and no CAT with antecedent infection has been reported to our knowledge. In addition, although some CAT in patients on hemodialysis has been reported to grow rapidly, no case has been reported on CAT that grew and diminished rapidly in a short period of time. Here, we report the case of an 82-year-old Japanese woman with normal renal function who developed multiple cerebral infarctions due to CAT that grew rapidly, associated with inflammation from an antecedent infection, and diminished rapidly by detachment of fibrin on the mass surface and antithrombotic drugs.

CASE PRESENTATION

The patient developed fever after dental treatment and found musical hallucination on the left ear worsened in degree and frequency. In a nearby clinic, she was treated with antibiotics, and her body temperature turned to normal in approximately 1 month. She presented to our hospital for workup on the worsened musical hallucination. Magnetic resonance imaging (MRI) showed multiple cerebral infarctions, and transthoracic echocardiography (TTE) revealed an immobile hyperechoic mass with an acoustic shadow arising from a posterior cusp of the mitral valve. CAT was suspected and treated with apixaban and aspirin. Follow-up MRI and TTE showed newly developed multiple cerebral infarctions and rapidly diminished CAT. Cardiac surgery was performed to resect the CAT. The pathological findings showed calcifications surrounded by amorphous fibrous tissue including fibrin, indicating CAT. The patient's symptoms improved and no cerebral infarctions recurred in 4 months follow-up.

CONCLUSION

Inflammation from an antecedent infection can cause CAT to grow rapidly. Fibrous tissue including fibrin may attach to the surface of CAT, resulting in multiple cerebral infarctions. Fibrous tissue may detach and disappear by antithrombotic drugs, leading to a rapid diminishment of CAT in size.

Swinging Calcified Amorphous Tumor in the Ascending Aorta

A 70-year-old woman with heart failure and end-stage renal disease on dialysis was found to have a 2.9 x 0.9 cm swinging mass attached to the posterior wall of the ascending aorta, 3 cm above the aortic valve. Due to risk of embolization, she underwent an aortotomy and mass excision. The mass had extensive calcifications with degenerative changes, and no evidence of malignancy. This represents an exceedingly rare location for a calcified amorphous tumour. Our review adds to the literature establishing the proximal aorta as a characterized location for a calcified amorphous tumour and provides a treatment approach to prevent embolization.