Figures legend:
Figure 1: Echocardiography showing an echoic mass of the posterior annulus with a central echolucency (arrow in A) and no color Doppler flow (arrow in B).
Figure 2: CMR showing a low signal mass of the posterior annulus (yellow arrow) with mitral regurgitation (arrowhead) on cine image (A). The mass has a central low signal with a peripheral high signal rim on STIR W images (red arrow, B) and a high signal on black blood T1W images (blue arrow, C). It shows a peripheral enhancement on late gadolinium enhancement sequences (white arrows, D – E – F).
Figure 3: cardiac CT without contrast material showing a fully calcified mass of the posterior annulus (arrows, A – B). CT in the work up of the breast cancer 8 years ago, showing tiny calcification of the posterior annulus (arrow, C)