Methodist Journal

FEATURED GUEST EDITOR

ISSUE INTRO

The Burgeoning Field of Cardio-Oncology

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RECOGNITIONS

Barry H. Trachtenberg Leads Issue on Cardio-Oncology

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REVIEW ARTICLES See More

Heart Failure in Relation to Anthracyclines and Other Chemotherapies

Heart Failure in Relation to Tumor-Targeted Therapies and Immunotherapies

The Role of Cardiovascular Imaging and Serum Biomarkers in Identifying Cardiotoxicity Related to Cancer Therapeutics

Prevention and Treatment of Chemotherapy-Induced Cardiotoxicity

Cardiovascular Toxicities of Radiation Therapy

Electrophysiologic Complications in Cancer Patients

Vascular Toxicity in Patients with Cancer: Is There a Recipe to Clarify Treatment?

Future Directions in Cardio-Oncology

CASE REPORTS See More

A Rare Case of Pancreatitis-Induced Thrombosis of the Aorta and Superior Mesenteric Artery

Anomalous Origin of the Right Coronary Artery from the Left Main Coronary Artery in the Setting of Critical Bicuspid Aortic Valve Stenosis

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Do Not Pass Flow: Microvascular Obstruction on Cardiac Magnetic Resonance After Reinfarction Following Primary Percutaneous Coronary Intervention

CLINICAL PERSPECTIVES See More

EXCERPTA

Cardio-Oncology, Then and Now: An Interview with Barry Trachtenberg

POINTS TO REMEMBER

Onconephrology: An Evolving Field

POINTS TO REMEMBER

Herbal Nephropathy

EXCERPTA

Rolling the Dice on Red Yeast Rice

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 11, Issue 2 (2015)

Article Full Text

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER

Multimodality Imaging of a Cardiac Pseudotumor

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Article Citation:

Danai Kitkungvan, Corinne Bontiff, Michael Reardon, and Faisal Nabi. Multimodality Imaging of a Cardiac Pseudotumor. Methodist DeBakey Cardiovascular Journal. April 2015, Vol. 11, No. 2, pp. 146.

doi: https://doi.org/10.14797/mdcj-11-2-146

Keywords
cardiac pseudotumor , left atrial mass

A 77-year-old asymptomatic female who had recently undergone 2-vessel coronary artery bypass surgery was referred from another hospital for surgical removal of a left atrial mass that was found on a recent transthoracic echocardiogram (TTE).

Cardiac magnetic resonance imaging was obtained for further anatomical evaluation and tissue characterization. Cine-steady state free precession imaging demonstrated a large, well-circumscribed mass involving the posterolateral mitral annulus without surrounding tissue invasion or compromise to mitral valvular function. T1 turbo spin-echo and T2 turbo spin-echo with fat suppression images showed the mass to be hypointense to myocardium (A and B, arrows), indicating an absence of significant fat or fluid. Absence of resting first-pass perfusion with gadolinium contrast administration indicated a lack of vascularity (C, arrow). Delayed hyperenhancement imaging showed a characteristic pattern of peripheral rim hyperenhancement consistent with a fibrous cap and a dark avascular core (D, arrow). These findings are most consistent with caseous mitral annular calcification. This was then verified with noncontrast cardiac computed tomography that demonstrated a large, hyperdense, calcified mass (F, arrow).

Multimodality imaging of a cardiac pseudotumor

Once TTE images could be obtained, review of the outside images (apical 4-chamber) similarly demonstrated a large, round, echodense mass at the posterior mitral annulus (E, arrow). Mitral valve function was normal without evidence of either mitral regurgitation or mitral stenosis. The patient was reassured of its benign prognosis, and conservative management/observation was advised.

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