Multimodality Imaging of a Rare Case of Cardiac Calcified Amorphous Tumour in an Asymptomatic Patient

1. Junior Resident, Department of Radiodiagnosis, Agartala Government Medical College and GB Hospital, Agartala, Tripura, India. 2. Associate Professor, Department of Radiodiagnosis, Agartala Government Medical College, Agartala, Tripura, India. 3. Junior Resident, Department of Radiodiagnosis, Agartala Government Medical College and GB Hospital, Agartala, Tripura, India. 4. Associate Professor, Department of Radiodiagnosis, Agartala Government Medical College, Agartala, Tripura, India. 5. Senior Resident, Department of Radiodiagnosis, Agartala Government Medical College, Agartala, Tripura, India.

Abstract

Calcified Amorphous Tumour (CAT) of the heart (cardiac CAT) is a rare non-neoplastic cardiac mass that mimics malignancy on imaging and can cause symptoms due to flow obstruction or embolisation of calcific fragments. However, most of the time, the tumour may remain asymptomatic and is incidentally detected on transthoracic echocardiograms and Computed Tomography (CT) thorax. Cardiac CT and/or cardiac Magnetic Resonance Imaging (MRI) are used as problem-solving tools to support the diagnosis made by echocardiography. We report a unique case of a cardiac CAT in a completely asymptomatic 52-year-old male patient who came for a routine annual health check-up. Under the panel of investigations, the patient underwent a CT chest. Although the lung fields were unremarkable, a calcified lesion was detected in the mediastinum, which, after applying the volume rendering technique, was localised in the Right Atrium (RA). Following this incidental finding, the patient underwent a battery of investigations, including an echocardiogram and a cardiac MRI, after which the calcified amorphous and benign nature of the tumour was finally identified. Although benign, such tumours can have catastrophic effects if they produce mass effects, resulting in abnormal sinus rhythm or deranged filling of heart chambers. Therefore, the detection, work-up, and follow-up of such tumours is mandatory, and if symptomatic, surgical resection is indicated.

Cardiac magnetic resonance imaging, Computed tomography scan, Echocardiogram