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Infiltrating Lipoma of the Right Ventricle Involving the Interventricular Septum and Tricuspid Valve

View Article: PubMed Central - PubMed

ABSTRACT

Cardiac lipoma, which are primary cardiac tumors, are rare entities often detected incidentally during imaging. There have been very few reports on the right ventricle (RV) lipoma. Here, we present a case of RV infiltrating lipoma involving the interventricular septum (IVS) and the tricuspid valve. Clinical symptoms, diagnostic procedures, multimodality imaging characteristics, and treatment are discussed, and the complete clinical data of this case and relevant details of retrospective literature are reviewed. The study described the case of a 48-year-old woman who suffered from occasional palpitation after exertion for 10 years. Imaging examinations, including echocardiography and cardiovascular magnetic resonance imaging (MRI), revealed a large mass adherent to the IVS and the right ventricular wall that was consistent with lipoma. The patient underwent surgical repair of the tricuspid valve and excision of the partial mass. The gross specimen revealed piles of 5 × 4 × 3 cm fragments with yellowish appearance and pathological results showed infiltrating lipoma.

Lipoma is often asymptomatic and diagnosed incidentally. Surgical excision is the main therapeutic intervention, which is always performed in cases of symptomatic lipoma or when malignancy is suspected. Multimodality imaging would be great help in the diagnosis of cardiac lipoma. Echocardiography is a convenient method for follow-up.

No MeSH data available.


Related in: MedlinePlus

Contrast enhancement ultrasound findings show few contrast agent enhancements in the tumor structure (white arrow; A); real-time 3D full-volume bird's eye view findings of the mass adherent to the IVS and attached to the RV wall (B). IVS = interventricular septum; MV = bicuspid valve; RV = right ventricle.
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Figure 2: Contrast enhancement ultrasound findings show few contrast agent enhancements in the tumor structure (white arrow; A); real-time 3D full-volume bird's eye view findings of the mass adherent to the IVS and attached to the RV wall (B). IVS = interventricular septum; MV = bicuspid valve; RV = right ventricle.

Mentions: 2D-TTE (Philips IE33; Philips Healthcare, Eindhoven, Netherlands) demonstrated an irregular hyperechoic mass adherent to the IVS with a broad base (Figure 1A). The size of the mass was 4.4 × 3.0 × 2.4 cm3 and the left ventricular ejection fraction was 67%. Incidentally, another echogenic mass measuring 4.6 × 1.5 cm was observed to be adherent to the RV wall (Figure 1B); it was irregular and showed good mobility. In the subxiphoid 4-chamber view, the mass was adherent to the IVS and the RV wall (Figure 1C and D). Color Doppler flow imaging (CDFI) did not detect any flow signal inside the mass. The flow of the RV outflow tract and the tricuspid orifice were not obstructed and mild tricuspid regurgitation was detected in systole. CEUS demonstrated that there was a slight enhancement of the contrast agent inside the mass (Figure 2A). However, subsequent RT-3DE showed the involved scope of the mass was nearly attached to the right ventricular apex (Figure 2B). In conclusion, the diagnosis was an irregular RV mass located in the right side of the IVS and the RV wall, which was probably connected.


Infiltrating Lipoma of the Right Ventricle Involving the Interventricular Septum and Tricuspid Valve
Contrast enhancement ultrasound findings show few contrast agent enhancements in the tumor structure (white arrow; A); real-time 3D full-volume bird's eye view findings of the mass adherent to the IVS and attached to the RV wall (B). IVS = interventricular septum; MV = bicuspid valve; RV = right ventricle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998283&req=5

Figure 2: Contrast enhancement ultrasound findings show few contrast agent enhancements in the tumor structure (white arrow; A); real-time 3D full-volume bird's eye view findings of the mass adherent to the IVS and attached to the RV wall (B). IVS = interventricular septum; MV = bicuspid valve; RV = right ventricle.
Mentions: 2D-TTE (Philips IE33; Philips Healthcare, Eindhoven, Netherlands) demonstrated an irregular hyperechoic mass adherent to the IVS with a broad base (Figure 1A). The size of the mass was 4.4 × 3.0 × 2.4 cm3 and the left ventricular ejection fraction was 67%. Incidentally, another echogenic mass measuring 4.6 × 1.5 cm was observed to be adherent to the RV wall (Figure 1B); it was irregular and showed good mobility. In the subxiphoid 4-chamber view, the mass was adherent to the IVS and the RV wall (Figure 1C and D). Color Doppler flow imaging (CDFI) did not detect any flow signal inside the mass. The flow of the RV outflow tract and the tricuspid orifice were not obstructed and mild tricuspid regurgitation was detected in systole. CEUS demonstrated that there was a slight enhancement of the contrast agent inside the mass (Figure 2A). However, subsequent RT-3DE showed the involved scope of the mass was nearly attached to the right ventricular apex (Figure 2B). In conclusion, the diagnosis was an irregular RV mass located in the right side of the IVS and the RV wall, which was probably connected.

View Article: PubMed Central - PubMed

ABSTRACT

Cardiac lipoma, which are primary cardiac tumors, are rare entities often detected incidentally during imaging. There have been very few reports on the right ventricle (RV) lipoma. Here, we present a case of RV infiltrating lipoma involving the interventricular septum (IVS) and the tricuspid valve. Clinical symptoms, diagnostic procedures, multimodality imaging characteristics, and treatment are discussed, and the complete clinical data of this case and relevant details of retrospective literature are reviewed. The study described the case of a 48-year-old woman who suffered from occasional palpitation after exertion for 10 years. Imaging examinations, including echocardiography and cardiovascular magnetic resonance imaging (MRI), revealed a large mass adherent to the IVS and the right ventricular wall that was consistent with lipoma. The patient underwent surgical repair of the tricuspid valve and excision of the partial mass. The gross specimen revealed piles of 5 × 4 × 3 cm fragments with yellowish appearance and pathological results showed infiltrating lipoma.

Lipoma is often asymptomatic and diagnosed incidentally. Surgical excision is the main therapeutic intervention, which is always performed in cases of symptomatic lipoma or when malignancy is suspected. Multimodality imaging would be great help in the diagnosis of cardiac lipoma. Echocardiography is a convenient method for follow-up.

No MeSH data available.


Related in: MedlinePlus