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A rare case report of giant epicardial lipoma compressing the right atrium with septal enhancement.

Wu S, Teng P, Zhou Y, Ni Y - J Cardiothorac Surg (2015)

Bottom Line: Cardiac Lipoma is a rare entity constituting approximately 10-19 % of primary tumors of the heart and pericardium.Due to the enhancement of the tumor septa, it was first diagnosed as liposarcoma and thought to be unresectable.Debulking surgery was performed to release patient's symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic Surgery, the First Affiliated Hospital of Zhejiang University, 79#, Qingchun Road, Hangzhou, Zhejiang, 310000, China. tptriston@hotmail.com.

ABSTRACT

Background: Cardiac Lipoma is a rare entity constituting approximately 10-19 % of primary tumors of the heart and pericardium. To our best knowledge, such a large cardiac lipoma with septal enhancement in our case has never been reported before.

Case presentation: Here we present a rare case of a 65-year-old symptomatic female with an unusual giant cardiac lipoma. Due to the enhancement of the tumor septa, it was first diagnosed as liposarcoma and thought to be unresectable. Debulking surgery was performed to release patient's symptoms.

Conclusions: The patient ultimately underwent complete tumor resection with uneventful postoperative evolution. The postoperative pathological diagnosis is cardiac lipoma.

No MeSH data available.


Related in: MedlinePlus

a Chest roentgenogram showed the water-bottle heart with enlarged cardiac silhouette. b Enhanced CT showed an intrapericardial low-density tumor encompassing the free wall of right atrium. The tumor was well circumscribed and the septa of the tumor presented with enhancement. c, d A giant lipoid mass was noted after pericardiotomy, which was yellow, soft and well-encapsulated. e The resected tumor measured about 14 × 11 cm, weighted about 450 g and was well-encapsulated. f Histopathological study confirmed the diagnosis of lipoma (H&E stain)
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Fig1: a Chest roentgenogram showed the water-bottle heart with enlarged cardiac silhouette. b Enhanced CT showed an intrapericardial low-density tumor encompassing the free wall of right atrium. The tumor was well circumscribed and the septa of the tumor presented with enhancement. c, d A giant lipoid mass was noted after pericardiotomy, which was yellow, soft and well-encapsulated. e The resected tumor measured about 14 × 11 cm, weighted about 450 g and was well-encapsulated. f Histopathological study confirmed the diagnosis of lipoma (H&E stain)

Mentions: On admission, the water bottle sign of the cardiac silhouette was found on the chest roentgenogram (Fig. 1a). Transthoracic echocardiography (TTE) revealed a large (10.2 × 7.5 × 3.8 cm) well-defined homogenous hypoechoic mass located in the pericardial cavity, encompassing the anterior walls of aorta and pulmonary artery. Further assessment by enhanced computed tomography (CT) showed a large lobulated low-density mass in the pericardial cavity (Fig. 1b). The tumor presented with septal enhancement and absence of parenchymal enhancement. Meanwhile, computed tomographic angiography (CTA) of the heart confirmed normal coronary arteries and no compression signs by the tumor. After extensive workup, a preoperative diagnosis of cardiac liposarcoma was made based on the extensive growth and the enhancement of the tumor septa, which made us believe complete tumor resection was of high difficulty. Debulking surgery was scheduled to release patient’s symptoms.Fig 1


A rare case report of giant epicardial lipoma compressing the right atrium with septal enhancement.

Wu S, Teng P, Zhou Y, Ni Y - J Cardiothorac Surg (2015)

a Chest roentgenogram showed the water-bottle heart with enlarged cardiac silhouette. b Enhanced CT showed an intrapericardial low-density tumor encompassing the free wall of right atrium. The tumor was well circumscribed and the septa of the tumor presented with enhancement. c, d A giant lipoid mass was noted after pericardiotomy, which was yellow, soft and well-encapsulated. e The resected tumor measured about 14 × 11 cm, weighted about 450 g and was well-encapsulated. f Histopathological study confirmed the diagnosis of lipoma (H&E stain)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4634815&req=5

Fig1: a Chest roentgenogram showed the water-bottle heart with enlarged cardiac silhouette. b Enhanced CT showed an intrapericardial low-density tumor encompassing the free wall of right atrium. The tumor was well circumscribed and the septa of the tumor presented with enhancement. c, d A giant lipoid mass was noted after pericardiotomy, which was yellow, soft and well-encapsulated. e The resected tumor measured about 14 × 11 cm, weighted about 450 g and was well-encapsulated. f Histopathological study confirmed the diagnosis of lipoma (H&E stain)
Mentions: On admission, the water bottle sign of the cardiac silhouette was found on the chest roentgenogram (Fig. 1a). Transthoracic echocardiography (TTE) revealed a large (10.2 × 7.5 × 3.8 cm) well-defined homogenous hypoechoic mass located in the pericardial cavity, encompassing the anterior walls of aorta and pulmonary artery. Further assessment by enhanced computed tomography (CT) showed a large lobulated low-density mass in the pericardial cavity (Fig. 1b). The tumor presented with septal enhancement and absence of parenchymal enhancement. Meanwhile, computed tomographic angiography (CTA) of the heart confirmed normal coronary arteries and no compression signs by the tumor. After extensive workup, a preoperative diagnosis of cardiac liposarcoma was made based on the extensive growth and the enhancement of the tumor septa, which made us believe complete tumor resection was of high difficulty. Debulking surgery was scheduled to release patient’s symptoms.Fig 1

Bottom Line: Cardiac Lipoma is a rare entity constituting approximately 10-19 % of primary tumors of the heart and pericardium.Due to the enhancement of the tumor septa, it was first diagnosed as liposarcoma and thought to be unresectable.Debulking surgery was performed to release patient's symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiothoracic Surgery, the First Affiliated Hospital of Zhejiang University, 79#, Qingchun Road, Hangzhou, Zhejiang, 310000, China. tptriston@hotmail.com.

ABSTRACT

Background: Cardiac Lipoma is a rare entity constituting approximately 10-19 % of primary tumors of the heart and pericardium. To our best knowledge, such a large cardiac lipoma with septal enhancement in our case has never been reported before.

Case presentation: Here we present a rare case of a 65-year-old symptomatic female with an unusual giant cardiac lipoma. Due to the enhancement of the tumor septa, it was first diagnosed as liposarcoma and thought to be unresectable. Debulking surgery was performed to release patient's symptoms.

Conclusions: The patient ultimately underwent complete tumor resection with uneventful postoperative evolution. The postoperative pathological diagnosis is cardiac lipoma.

No MeSH data available.


Related in: MedlinePlus