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Caseous calcification of the mitral annulus

Imaging findings

CT chest shows a dense, hyperdense mass-like calcification with a central region of low attenuation adjacent to the posterior mitral valve annulus, representing toothpaste-like caseous calcification of the mitral annulus.

Key takeaways

Caseous calcification of the mitral annulus (CCMA) is a benign variant of mitral annular calcification. It represents a liquefactive necrosis of a calcified annulus and classically presents as a round, calcified mass with a central non-enhancing core. It is frequently mistaken for a cardiac tumor, thrombus, or abscess.

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