Recurrent cardiac calcific amorphous tumor: the CAT had a kitten

Background: Cardiac calcified amorphous tumors (CATs) represent degenerating intracavitary mural thrombi that can mimic neoplasms and cause symptoms due to embolization or obstruction. Surgical excision is generally curative. Postoperative recurrences have not been previously reported. Methods: Medical, surgical, and pathological records were reviewed in a patient who had undergone removal of a recurrent cardiac CAT. Results: The patient, now a 23-year-old woman, had undergone excision of the initial right ventricular mass on November 4, 2003, because of recent pulmonary embolization. Extensive clinical evaluation showed no coagulation abnormality. Follow-up postoperative echocardiograms showed incomplete excision and subsequent enlargement. As a result, the recurrent mass was excised on March 14, 2006. Microscopic evaluation showed degenerating and focally calcifying thrombus, without neoplastic features. Conclusion: Cardiac CAT may recur and enlarge following surgical excision. Periodic postoperative follow-up with cardiac imaging studies may be indicated, particularly if there is evidence of incomplete excision.