Tumor-Like Mitral Annular Calcification with Central Liquefaction

Calcification of the mitral annulus is a degenerative process, which occurs mainly in older patients. Rarely, an extensive mitral annular calcification (MAC) with central liquefaction was reported. We report the case of extension of MAC into the adjacent left ventricular posterior wall along with central liquefaction and posterior mitral leaflet displacement in a 63-year-old woman. The abnormal size of the MAC and unusual echo density of pasty material inside made a correct diagnosis difficult and intracardiac tumor was suspected. Thus, similar uncommon clinical presentation of MAC should be considered in the differential diagnosis of intracardiac masses.