Long Term Follow up of Cardiac Calcified Amorphous Tumor in Major Thalassemia; A case series report

Introduction: Cardiac Calcified Amorphous Tumors (CATs) are rare non-neoplastic heart intracavitary mass lesions. Cardiac CATs may arise in any heart chamber and are characterized histopathologically by diffuse calcium infiltration. The recommended treatment of choice is complete resection of the mass through surgery. Herein, three cases with thalassemia were presented with significant CATs that remained asymptomatic during close observation without any surgical interventions.
Case Presentation: The three patients suffered from thalassemia. One of them had a calcified mass (3.8 × 0.74 cm) in the right ventricle in the vicinity of ventricular trabeculations, which prolapsed into the tricuspid valve orifice that resulted in moderate to severe tricuspid regurgitation without the development of any stenosis. Another case had an irregular calcified mass (2.3 × 0.75 cm) in the roof of the left atrium. The third case had a large calcified mass with a mobile component in right ventricular trabeculation. Surgical resection of the mass was recommended in all the cases, but they were closely monitored without surgical intervention. During the five-year follow-up, they remained totally asymptomatic and had no cardiovascular or cerebral events.
Conclusions: Immobile CATs in patients with thalassemia can be asymptomatic. Hence, they can be closely monitored and surgical intervention can be delayed for many years.