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Yamana F, Domae K, Shirakawa Y, Takahashi T, Hao H. Cardiac calcified amorphous tumor with sustained ventricular tachycardia. Asian Cardiovasc Thorac Ann 2021; 30:474-476. [PMID: 33926270 DOI: 10.1177/02184923211013999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cardiac calcified amorphous tumors are rare non-neoplastic intracavitary masses with unknown cause. A 60-year-old man presented with sustained ventricular tachycardia. Transthoracic echocardiography and contrast-enhanced angio-computed tomography demonstrated an expanding 73 × 40 mm sized calcified mass in the left ventricle. He underwent successful total removal of the mass and cryo-ablation at the normal myocardial border. Histopathological examination confirmed a diagnosis of cardiac calcified amorphous tumors. The postoperative course was uneventful, without ventricular tachycardia recurrence. To our knowledge, this is the first reported case of confirmed cardiac calcified amorphous tumors causing ventricular tachycardia and treated by surgical resection combined with cryo-ablation.
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Affiliation(s)
- Fumio Yamana
- Department of Cardiovascular Surgery, Osaka Police Hospital, Osaka, Japan
| | - Keitaro Domae
- Department of Cardiovascular Surgery, Osaka Police Hospital, Osaka, Japan
| | | | - Toshiki Takahashi
- Department of Cardiovascular Surgery, Osaka Police Hospital, Osaka, Japan
| | - Hiroyuki Hao
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
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2
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Okazaki A, Oyama Y, Hosokawa N, Ban H, Miyaji Y, Moody S. The First Report of Calcified Amorphous Tumor Associated with Infective Endocarditis: A Case Report and Review of Literature. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e922960. [PMID: 32374721 PMCID: PMC7226926 DOI: 10.12659/ajcr.922960] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Calcified amorphous tumor (CAT) of the heart is a rare non-neoplastic intracardiac mass, which is composed of calcium deposition surrounded by amorphous fibrous tissue. The clinical presentation of cardiac CAT resembles that of other cardiac tumors or vegetation, though there is no previous report of a CAT complicated with infective endocarditis. CASE REPORT A 67-year-old male with a history of end stage renal failure and gastric cancer who was on adjuvant chemotherapy presented with a cardiac mass. The mass was resected and diagnosed as CAT pathologically. Two separate sets of blood cultures were positive for Enterococcus faecalis, thus, the patient was diagnosed with infective endocarditis. Antibiotic treatment was continued for 6 weeks after surgery, and the patient recovered uneventfully. However, he died from a complication of his gastric cancer 5 months later. CONCLUSIONS This is the first report of CAT associated with infective endocarditis. Blood cultures should be obtained to differentiate infective endocarditis or CAT with infectious endocarditis from CAT alone, because CAT with infective endocarditis may present atypically and may be more likely to require antibiotic treatment along with surgery.
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Affiliation(s)
- Aiko Okazaki
- Department of Oncology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Yu Oyama
- Department of Oncology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Naoto Hosokawa
- Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Hirokazu Ban
- Department of Infectious Diseases, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Yasutomo Miyaji
- Department of Oncology, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Sandra Moody
- Department of Clinical Education, Kameda Medical Center, Kamogawa, Chiba, Japan
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Saku K, Tahara N, Takaseya T, Shintani Y, Takagi K, Shojima T, Kurata S, Fujimoto K, Abe T, Fukumoto Y, Tanaka H. Multimodal imaging of cardiac-calcified amorphous tumor. J Nucl Cardiol 2020; 27:682-685. [PMID: 30421382 DOI: 10.1007/s12350-018-01510-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 10/27/2022]
Abstract
Cardiac-calcified amorphous tumor (CAT) is a rare non-neoplastic tumor and its origin and pathogenesis are still unclear. In addition, it is difficult to clinically diagnose as cardiac CAT without pathological findings. We present a case of a 78-year-male diagnosed with cardiac CAT after surgical resection. We could evaluate tumor aspects by multimodal imaging including echocardiography, contrast-enhanced computed tomography (CT), magnetic resonance image, and 18F-fluorodeoxyglucose-positron emission tomography/CT before surgery.
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Affiliation(s)
- Kosuke Saku
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
| | - Nobuhiro Tahara
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
| | - Tohru Takaseya
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Yusuke Shintani
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Kazuyoshi Takagi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Takahiro Shojima
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Seiji Kurata
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Kiminori Fujimoto
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Hiroyuki Tanaka
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
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Tian F, Zhang L, Wang J, Li Y, Xie M. Multimodality imaging of a left atrial calcified amorphous tumor. Echocardiography 2019; 37:147-149. [PMID: 31825112 DOI: 10.1111/echo.14559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/12/2019] [Accepted: 11/21/2019] [Indexed: 11/27/2022] Open
Abstract
A cardiac calcified amorphous tumor (CAT) is an extremely rare non-neoplastic cardiac mass composed of calcium nodules in an amorphous background of fibrin materials. Herein, we report a case of CAT in the left atrium of an asymptomatic 72-year-old man who underwent multimodality imaging and successful resection of the CAT. Results of the present case suggest that multimodality imaging plays an important role in detecting cardiac CAT, determining the treatment plan and serial follow-ups for the patients after the treatment.
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Affiliation(s)
- Fangyan Tian
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Li Zhang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Jing Wang
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yuman Li
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Mingxing Xie
- Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
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Shah AC, Marcoff L, Talati S, Donahue J, Uretsky S, Magovern C, Gillam LD. A Rare Beast: Cardiac Calcified Amorphous Tumor. ACTA ACUST UNITED AC 2018; 2:139-141. [PMID: 30128412 PMCID: PMC6098182 DOI: 10.1016/j.case.2018.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CAT is a non-neoplastic intracardiac mass of uncertain etiology. Cardiac CAT has been found in various locations in the heart. Most cases are treated surgically, but conservative management may be preferred. Echocardiography plays a central role in the diagnosis and follow-up of cardiac CAT.
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Affiliation(s)
- Amit C Shah
- Department of Internal Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey
| | - Leo Marcoff
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey
| | - Sapan Talati
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey
| | - John Donahue
- Department of Pathology, Gagnon Cardiovascular Institute, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey
| | - Seth Uretsky
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey
| | - Christopher Magovern
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey
| | - Linda D Gillam
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey
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Yoshimura S, Kawano H, Minami T, Tsuneto A, Nakata T, Koga S, Ikeda S, Hayashi T, Maemura K. Cardiac Calcified Amorphous Tumors in a Patient with Hemodialysis for Diabetic Nephropathy. Intern Med 2017; 56:3057-3060. [PMID: 28943588 PMCID: PMC5725860 DOI: 10.2169/internalmedicine.9057-17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Calcified amorphous tumor (CAT) is a rare, non-neoplastic tumor involving calcium deposition in amorphous materials. Although its etiology is unknown, cases have frequently been reported in patients with hemodialysis for chronic kidney disease. We herein describe a case of cardiac CAT in a 64-year-old woman who had been on hemodialysis for diabetic nephropathy for 20 years, and the findings of the present patient, in association with the findings of previous case reports, suggest that end-stage renal disease seems to play an important role in the onset of CAT, especially in CAT formation at the mitral annulus, which appears to differ from CAT occurring at other sites.
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Affiliation(s)
- Satoshi Yoshimura
- Department of Cardiology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Hiroaki Kawano
- Department of Cardiology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Takako Minami
- Department of Cardiology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Akira Tsuneto
- Department of Cardiology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Tomoo Nakata
- Department of Cardiology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Seiji Koga
- Department of Cardiology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Satoshi Ikeda
- Department of Cardiology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | | | - Koji Maemura
- Department of Cardiology, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Yılmaz R, Demir AA, Önür İ, Yılbazbayhan D, Dursun M. Cardiac calcified amorphous tumors: CT and MRI findings. Diagn Interv Radiol 2017; 22:519-524. [PMID: 27705878 DOI: 10.5152/dir.2016.16075] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to evaluate computed tomography (CT) and magnetic resonance imaging (MRI) findings of cardiac calcified amorphous tumors (CATs). METHODS CT and MRI findings of cardiac CATs in 12 patients were included. We retrospectively examined patient demographics, location, size, shape configuration, imaging features, calcification distribution of tumors, and accompanying medical problems. RESULTS There was a female predominance (75%), with a mean age at presentation of 65 years. Patients were mostly asymptomatic on presentation (58.3%). The left ventricle of the heart was mostly involved (91%). CT findings of CATs were classified as partial calcification with a hypodense mass in four patients or a diffuse calcified form in eight. Calcification was predominant with large foci appearance as in partially calcified masses. On T1- and T2-weighted magnetic resonance images, CATs appeared hypointense and showed no contrast enhancement. CONCLUSION The shape and configuration of cardiac CATs are variable with a narrow spectrum of CT and MRI findings, but large foci in a partially calcified mass or diffuse calcification of a mass on CT is very important in the diagnosis of cardiac CATs. Masses show a low signal intensity on T1- and T2-weighted images with no contrast enhancement on MRI.
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Affiliation(s)
- Ravza Yılmaz
- Department of Radiology, İstanbul University School of Medicine, İstanbul, Turkey.
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Singu T, Inatomi Y, Yonehara T, Ando Y. Calcified Amorphous Tumor Causing Shower Embolism to the Brain: A Case Report with Serial Echocardiographic and Neuroradiologic Images and a Review of the Literature. J Stroke Cerebrovasc Dis 2017; 26:e85-e89. [PMID: 28318955 DOI: 10.1016/j.jstrokecerebrovasdis.2017.02.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 01/29/2017] [Accepted: 02/15/2017] [Indexed: 11/24/2022] Open
Abstract
An 89-year-old woman with chronic atrial fibrillation, hypertension, chronic heart failure, and dementia was admitted to our hospital due to multiple small cerebral and cerebellar infarctions. Transthoracic echocardiogram revealed a floating calcified mass lesion arising from the endocardium of the posterior portion of the mitral annulus with mitral annular calcification. Furthermore, the mass had a heterogeneity of the echogenicity. The mass was diagnosed as a calcified amorphous tumor based on specific echocardiographic features. Serial echocardiograms showed shrinkage and disappearance of the mass, and magnetic resonance image revealed new infarction in the left occipital lobe. Embolization of the mass appeared to cause systemic embolism.
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Affiliation(s)
- Takaomi Singu
- Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
| | - Yuichiro Inatomi
- Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Toshiro Yonehara
- Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Yukio Ando
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Maemura S, Amiya E, Seki H, Ueda K, Nitta D, Imamura T, Uehara M, Kawata T, Watanabe M, Hatano M, Kinugawa K, Komuro I. Endomyocardial Fibrosis Associated With Apical Calcification and High Uptake on Myocardial Gallium-67 Scintigraphy. Circ J 2016; 80:2053-2055. [DOI: 10.1253/circj.cj-16-0512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Sonoko Maemura
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Hikari Seki
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Kazutaka Ueda
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Daisuke Nitta
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Teruhiko Imamura
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Masae Uehara
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Takayuki Kawata
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Masafumi Watanabe
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Masaru Hatano
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | | | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
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