Image in Cardiology
Amorphous tumor of the mitral valve
Tumor amorfo da válvula mitral
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The histological findings are characteristic, including calcification and amorphous fibrinous material. Its exact etiology is unknown.</p><p id="par0055" class="elsevierStylePara elsevierViewall">A 79-year-old woman was referred to our department because of suspected angina. The electrocardiogram showed ventricular repolarization abnormalities in the lateral wall. Transthoracic echocardiography showed preserved biventricular systolic function, without wall motion abnormalities, a mitral valve with normal functional area and marked calcification of the annulus, and on the ventricular side a hyperechoic, threadlike and highly mobile mass, protruding into the left ventricular outflow tract, causing a dynamic gradient of 24 mmHg (<a class="elsevierStyleCrossRef" href="#sec0060">Video 1</a>). Transesophageal echocardiography (TEE) showed a mass adjacent to the posterior annulus of the mitral valve, measuring about 25 mm×5 mm (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>; <a class="elsevierStyleCrossRef" href="#sec0060">Video 2 and 3</a>). Computed tomography confirmed a large calcified mass attached to the ventricular side of the mitral valve (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>). No mass was observed on cardiac magnetic resonance imaging, probably due to its marked mobility. Myocardial perfusion scintigraphy showed evidence of inferolateral ischemia and cardiac catheterization revealed left main and three-vessel disease. Bypass surgery was performed and the intraventricular tumor was removed (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>). Histology confirmed the diagnosis of calcified amorphous tumor (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Calcified amorphous tumor is a rare cardiac lesion with an excellent outcome. The clinical presentation is similar to other cardiac tumors, and surgical removal and histopathological examination are essential for an accurate diagnosis.</p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0035" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0065" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-12-17" "fechaAceptado" => "2016-01-10" "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0085" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia><elsevierMultimedia ident="upi0015"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0060" ] ] ] ] "multimedia" => array:7 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 628 "Ancho" => 600 "Tamanyo" => 49747 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Two-dimensional transesophageal echocardiography, long-axis view (120°), showing a mass adjacent to the mitral posterior annulus (yellow arrow), directed toward the left ventricular outflow tract (white arrow).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 674 "Ancho" => 600 "Tamanyo" => 53779 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Computed tomography, reformatted oblique sagittal view, depicting a dense calcified mass (white arrow).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 642 "Ancho" => 600 "Tamanyo" => 41494 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Surgical specimen.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 747 "Ancho" => 700 "Tamanyo" => 118673 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Histology showing dystrophic calcifications and fibrosis, with no other changes and no evidence of inflammation or tumor.</p>" ] ] 4 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 1278881 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] 5 => array:5 [ 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| 2023 Fevereiro | 40 | 23 | 63 |
| 2023 Janeiro | 47 | 14 | 61 |
| 2022 Dezembro | 64 | 25 | 89 |
| 2022 Novembro | 64 | 29 | 93 |
| 2022 Outubro | 55 | 27 | 82 |
| 2022 Setembro | 41 | 34 | 75 |
| 2022 Agosto | 35 | 40 | 75 |
| 2022 Julho | 49 | 43 | 92 |
| 2022 Junho | 47 | 39 | 86 |
| 2022 Maio | 31 | 37 | 68 |
| 2022 Abril | 50 | 40 | 90 |
| 2022 Maro | 36 | 50 | 86 |
| 2022 Fevereiro | 37 | 38 | 75 |
| 2022 Janeiro | 33 | 27 | 60 |
| 2021 Dezembro | 37 | 37 | 74 |
| 2021 Novembro | 52 | 42 | 94 |
| 2021 Outubro | 39 | 43 | 82 |
| 2021 Setembro | 34 | 24 | 58 |
| 2021 Agosto | 40 | 34 | 74 |
| 2021 Julho | 20 | 17 | 37 |
| 2021 Junho | 35 | 29 | 64 |
| 2021 Maio | 42 | 40 | 82 |
| 2021 Abril | 67 | 39 | 106 |
| 2021 Maro | 67 | 25 | 92 |
| 2021 Fevereiro | 60 | 22 | 82 |
| 2021 Janeiro | 40 | 15 | 55 |
| 2020 Dezembro | 45 | 15 | 60 |
| 2020 Novembro | 36 | 25 | 61 |
| 2020 Outubro | 39 | 19 | 58 |
| 2020 Setembro | 74 | 32 | 106 |
| 2020 Agosto | 29 | 8 | 37 |
| 2020 Julho | 55 | 15 | 70 |
| 2020 Junho | 57 | 12 | 69 |
| 2020 Maio | 29 | 5 | 34 |
| 2020 Abril | 37 | 8 | 45 |
| 2020 Maro | 49 | 17 | 66 |
| 2020 Fevereiro | 95 | 16 | 111 |
| 2020 Janeiro | 38 | 8 | 46 |
| 2019 Dezembro | 38 | 9 | 47 |
| 2019 Novembro | 27 | 13 | 40 |
| 2019 Outubro | 39 | 15 | 54 |
| 2019 Setembro | 48 | 8 | 56 |
| 2019 Agosto | 36 | 12 | 48 |
| 2019 Julho | 58 | 12 | 70 |
| 2019 Junho | 46 | 16 | 62 |
| 2019 Maio | 57 | 19 | 76 |
| 2019 Abril | 46 | 13 | 59 |
| 2019 Maro | 79 | 13 | 92 |
| 2019 Fevereiro | 89 | 8 | 97 |
| 2019 Janeiro | 70 | 12 | 82 |
| 2018 Dezembro | 54 | 19 | 73 |
| 2018 Novembro | 73 | 16 | 89 |
| 2018 Outubro | 109 | 18 | 127 |
| 2018 Setembro | 45 | 10 | 55 |
| 2018 Agosto | 21 | 12 | 33 |
| 2018 Julho | 28 | 8 | 36 |
| 2018 Junho | 47 | 7 | 54 |
| 2018 Maio | 42 | 6 | 48 |
| 2018 Abril | 70 | 6 | 76 |
| 2018 Maro | 59 | 9 | 68 |
| 2018 Fevereiro | 65 | 3 | 68 |
| 2018 Janeiro | 42 | 3 | 45 |
| 2017 Dezembro | 61 | 12 | 73 |
| 2017 Novembro | 45 | 10 | 55 |
| 2017 Outubro | 25 | 10 | 35 |
| 2017 Setembro | 27 | 13 | 40 |
| 2017 Agosto | 33 | 11 | 44 |
| 2017 Julho | 17 | 15 | 32 |
| 2017 Junho | 28 | 9 | 37 |
| 2017 Maio | 24 | 7 | 31 |
| 2017 Abril | 11 | 5 | 16 |
| 2017 Maro | 29 | 8 | 37 |
| 2017 Fevereiro | 31 | 5 | 36 |
| 2017 Janeiro | 35 | 19 | 54 |
| 2016 Dezembro | 71 | 53 | 124 |
| 2016 Novembro | 0 | 9 | 9 |
Mostrar tudo
