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06 May 2020 : Case report  Japan

The First Report of Calcified Amorphous Tumor Associated with Infective Endocarditis: A Case Report and Review of Literature

Rare disease

Aiko Okazaki1ABCDEF*, Yu Oyama1AB, Naoto Hosokawa2AB, Hirokazu Ban2ABEF, Yasutomo Miyaji1AB, Sandra Moody3EF

DOI: 10.12659/AJCR.922960

Am J Case Rep 2020; 21:e922960

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.

Keywords: Cardiac Imaging Techniques, Endocarditis, Bacterial, Enterococcus faecalis, Heart Neoplasms, Aged, Calcinosis, Endocarditis, Gram-Positive Bacterial Infections, Male

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923