Giant Interatrial Septal Lipoma Filling the Right Atrium Causing Slight Symptoms: A Case Report

Cardiac lipoma is extremely rare. Here, we present a unique illustrative case of an interatrial septal lipoma protruding into the right atrium, causing symptoms in a 54-year-old male. Echocardiogram and computed tomography showed a well-shaped, giant, and fixed mass located in the interatrial septum and right atrium. The only manifestation was palpitation, though the mass filled almost all of the atrium and compressed the superior vena cava. The patient received resection of the large-sized lipoma, which was 87mm in diameter and weighed 300-400g. Pathological exam demonstrated mature lipocytes and substantiated the diagnosis of lipoma. The patient did well postoperatively, and symptoms were resolved.

Giant Interatrial Septal Lipoma Filling with Right Atrium Causing Slight Symptoms: A Case Report

Cardiac lipoma is extremely rare. Here we presented a unique illustrative case of interatrial septal lipoma protruding into right atrial causing symptoms in a 54-year-old male. Echocardiogram and computed tomography showed a well-shaped, giant and fixed occupying located in interatrial septum and right atrium. The only manifestation was palpitation though the mass filled almost all atrium and compressed superior vena cava. The patient received resection of the large-sized lipoma sizing 87mm in diameter and weighing ~1000g. Pathological exam demonstrated mature lipocytes and substantiated the diagnosis of lipoma. The patient did well postoperatively and symptoms were resolved.

Following the written path -- a patient's journey to finding care!

Incidental cardiac tumors are rare and mostly detected on autopsy as patients largely remain asymptomatic. However, diagnosis of an incidental cardiac mass on unrelated work up can pose significant ethical and clinical challenge to the care team. Surgical resection has been the most successful intervention for most primary cardiac tumors however, it involves cardiopulmonary bypass assisted major surgery which is not risk free either. Cardiac lipoma is the second most common primary cardiac benign tumor. We report a case of a young otherwise healthy patient who reported have a cardiac lipoma on computerized tomography (CT ) scan that was done to rule out kidney stone.

The value of multimodality imaging in diagnosis and treatment of cardiac lipoma

Background Cardiac lipoma is a rare primary tumor in the heart and pericardium. Multimodality imaging methods, especially magnetic resonance imaging (MRI), are crucial in detecting and diagnosing cardiac lipomas. Besides, they are of significant importance in management of cardiac lipomas. The aim of this study was to evaluate the value of multimodality imaging methods in diagnosing and treatment of cardiac lipoma by describing a series of cases of cardiac lipoma. Materials and methods Data of patients with cardiac lipoma at a local institution were retrospectively collected. Their imaging findings on echocardiography, computed tomography (CT), and cardiac MRI and clinical management were described in detail. Results 12 patients with cardiac lipoma were retrospectively included with thirteen lipomas found within heart and pericardium. Two patients’ lipoma were symptomatic, while lipomas in other 10 patients were found incidentally. Most lipomas were sensitively detected with echocardiography. Accurate diagnoses were achieved with CT and MRI in all cases. Surgical resection was performed in one symptomatic patient due to the obstruction of the left ventricular outflow tract, while the removal of pericardial lipoma in another symptomatic patient was not possible due to diffuse myocardial infiltration observed in MRI. Based on MRI findings, two patients without clinical symptoms also underwent surgery to prevent the risk of detachment of ventricular lipoma with a narrow pedicle in one patient and potential further thinning of the myocardium by pericardial lipoma growth in another patient. Conclusions Cardiac lipoma could be sensitively detected and accurately diagnosed with multiple noninvasive imaging tools. Comprehensive evaluation with multimodality imaging methods should also be conducted for better management planning and follow-up in all patients.

The Value of Multimodality Imaging in Diagnosis and Treatment of Cardiac Lipoma

Background: Cardiac lipoma is a rare primary tumor in the heart and pericardium. Multimodality imaging methods, especially magnetic resonance imaging (MRI), are crucial in detecting and diagnosing cardiac lipomas. Besides, they are of significant importance in management of cardiac lipomas. The aim of this study was to evaluate the value of multimodality imaging methods in diagnosing and treatment of cardiac lipoma by describing a series of cases of cardiac lipoma.Materials and Methods: Data of patients with cardiac lipoma at a local institution were retrospectively collected. Their imaging findings on echocardiography, computed tomography (CT), and cardiac MRI and clinical management were described in detail. Results: 12 patients with cardiac lipoma were retrospectively included with thirteen lipomas found within heart and pericardium. Two patients’ lipoma were symptomatic, while lipomas in other 10 patients were found incidentally. Most lipomas were sensitively detected with echocardiography. Accurate diagnoses were achieved with CT and MRI in all cases. Surgical resection was performed in one symptomatic patient due to the obstruction of the left ventricular outflow tract, while the removal of pericardial lipoma in another symptomatic patient was not possible due to diffuse myocardial infiltration observed in MRI. Based on MRI findings, two patients without clinical symptoms also underwent surgery to prevent the risk of detachment of ventricular lipoma with a narrow pedicle in one patient and potential further thinning of the myocardium by pericardial lipoma growth in another patient. Conclusions: Cardiac lipoma could be sensitively detected and accurately diagnosed with multiple noninvasive imaging tools. Comprehensive evaluation with multimodality imaging methods should also be conducted for better management planning and follow-up in all patients.

From pathogenesis to treatment, a systemic review of cardiac lipoma

Cardiac lipoma is an uncommon primary cardiac tumor. With the advancement of diagnostic methods and treatment techniques, more cases of cardiac lipomas have been reported and suggest that the entity previously widely thought to display classic features may also show atypical findings. A systemic review of the rare cardiac tumor was done by searching the literature of cardiac lipoma. We endeavor to summarize the clinical features of the rare disease from pathogenesis to treatment. Literature of cardiac lipoma was retrospectively searched through PubMed and 255 cases of cardiac lipoma were included into this analysis. Cardiac lipomas can occur anywhere within the heart, 53.1% were located within the cardiac chambers, 32.5% in the pericardium, 10,7% within the myocardium and 3.7% involved multiple structures. More than half of the reported cardiac lipomas (66%) may be clinically symptomatic, presenting with symptoms ranging from chest discomfort to syncope depending on their size and location as well as extent of myocardial involvement. Noninvasive cardiac imaging has replaced the role of autopsy and cardiothoracic surgery in detection and diagnosis of cardiac lipomas. Most symptomatic patients (83.7%) were treated by resection of cardiac lipomas and 68.3% of asymptomatic patients also underwentprophylactic resection. Overgrowth and myocardial infiltration of lipomas may result in unsuccessful resection. Recurrence of cardiac lipomas was rare but reported in a few cases. The early detection and accurate diagnosis of cardiac lipoma is of great significance in clinical management, to avoid an unfavourable outcome due to overgrowth.