Image of the week - 17 December 2025

A 33-year-old man with end-stage renal disease on haemodialysis and poorly controlled hypertension is admitted following an afebrile ischaemic stroke. Imaging suggests an embolic origin. What is the most likely diagnosis?
 
 
Endocarditis abscess
Myxoma
Calcified thrombus
Caseous calcification of the mitral annulus
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