ABSTRACT Mitral Annular Calcification (MAC) is a degenerative process involving the fibrous ring of the mitral valve. Caseous Calcification of Mitral Annulus (CCMA) is a rare variant of MAC. This condition is benign and usually needs no treatment. This is a case report of a 67-year-old woman with non-specific symptoms in whom a cardiac tumor was suspected by transthoracic Echocardiography. The use of multi-modality imaging strategy with transesophageal Echocardiography and cardiac MR scanning revealed however the diagnosis of CCMA and spared the patient an unnecessary operation.
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