ABSTRACT
Key Clinical Message: Caseous mitral annulus calcification is a rare benign condition that can be misdiagnosed on echocardiography especially when it presents as a mass. This report highlights the contribution of cardiac MRI and computed tomography to the diagnosis through the case of a patient previously treated for breast cancer. Abstract: We report the case of a patient, previously treated for breast cancer, in whom echocardiography suggested the diagnosis of a cardiac tumor due the presence of a mass on the posterior mitral annulus. Cardiac magnetic resonance was inconclusive. Computed tomography confirmed the diagnosis of caseous mitral annulus calcification.
ABSTRACT
INTRODUCTION: Radiofrequency ablathermia of pulmonary nodules is a local curative treatment whose efficacy assessment is still a current topic. AIMS: To specify the monitoring protocol, the scannographic aspects of treated lesions, deduce criteria of incomplete ablation, and identify the prognostic factors influencing overall and progression-free survivals. METHODS: A prognostic descriptive retrospective study conducted in the medical imaging department of Abderrahman Mami Hospital. The nodules were monitored at 24-hour, 2.4,6,9,12,15,18 and 24 months after treatment and then once a year. The study of overall and progression-free survivals was done using Kaplan Meier's method. RESULTS: Sixteen patients with 21 nodules were included, 20% of them were pulmonary carcinomas and 80% were secondary nodules. 6 nodules presented an incomplete response.The appearance of a convex outline was the first sign of incomplete ablation. 5 out of 6 nodules had a nodular focal enhancement. The cumulative probability of overall survival at 12, 36, and 60 months was 80%, 66% and 39% with a median survival of 31 months. The number of nodules treated was found to be directly related to overall survival. The cumulative probability of progression-free survival was 65% at 12, 36 and 60 months. Pleural contact was the factor influencing progression-free survival. CONCLUSION: Radiofrequency ablathermia is an effective technique. Regular CT monitoring allows early detection of tumor recurrence.