Implication of eruption of caseous calcification of mitral annulus

A 74-year-old female with caseous calcification of the mitral annulus and interstitial pneumonia was admitted with stroke due to calcific emboli. Computed tomography revealed an oval calcification with homogeneous density in and scattered calcification under the posterior mitral annulus, which was detected for the first time. Computed tomography performed during treatment for pneumonia and stroke showed changes in the shape and density of the caseous calcification; however, scattered calcification under the mitral annulus persisted. Operative findings were consistent with the signs on computed tomography: a white, soft, plaster-like content and similar scattered material around the chordae of the posterior leaflet.