Туморска маса у срчаном мишићу: дијагностичка дилема

Abstract

Introduction Mitral annular calcification is a degenerative process of the fibrosus support structure of the mitral apparatus, usually spreading over the posterior mitral leaflet.

Case Outline A 66-year-old woman with shortness of breath and palpitations was referred to our institution. Echocardiography showed a round, echo-dense mass, resembling a tumour, in the posterior mitral annulus, with the third degree mitral regurgitation. Based on the findings, surgical treatment was suggested involving removal of the tumour and correction of mitral valve insufficiency. During surgery the posterior annulus was incised, whitish caseous material was aspirated and the developed cavity was closed. A bioprosthetic valve was placed in the mitral position. The aspirated material was sent to bacteriological and histological analysis. Eight days after surgery control echocardiography and CT scan of the heart showed absence of the mass. Pathohistological finding was nonspecific. Bacteriology showed Staphylococus spp. Thirteen days after surgery the patient was discharged in stabile condition.

Conclusion Mitral annular calcification is a common degenerative disorder particularly in elderly persons. As the diagnosis very often remains unrecognised imitating a tumor formation, precise diagnostics is necessary before possible surgery.

Keywords: intracardiac mass; mitral calcification; tumour