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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.


An echogenic RV mass is seen on transthoracic echocardiography. The horizontal, long-axis (4-chamber view), T1-weighted, black-blood image showing a well-circumscribed, high-signal mass in the RV cavity (arrow, A). The horizontal, long-axis, T1-weighted black-blood image showing the mass adherent to IVS (arrow, B). IVS = interventricular septum; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.
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Figure 3: An echogenic RV mass is seen on transthoracic echocardiography. The horizontal, long-axis (4-chamber view), T1-weighted, black-blood image showing a well-circumscribed, high-signal mass in the RV cavity (arrow, A). The horizontal, long-axis, T1-weighted black-blood image showing the mass adherent to IVS (arrow, B). IVS = interventricular septum; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.

Mentions: To further characterize the mass, the patient underwent cardiovascular MRI. Images revealed a homogeneous high-signal intensity within a quite irregular mass, which was adherent to the RV side of the IVS with a broad base that measured approximately 4.0 × 1.6 cm in maximal transverse diameter (Figure 3). The mass extended to the RV wall. The signal characteristics of the mass were similar to those of the thoracic muscle tissue signal on true-fast imaging with steady-state free precession (TRUFI) sequence images; thus, the lesion was suspected to be a lipoma.


Infiltrating Lipoma of the Right Ventricle Involving the Interventricular Septum and Tricuspid Valve
An echogenic RV mass is seen on transthoracic echocardiography. The horizontal, long-axis (4-chamber view), T1-weighted, black-blood image showing a well-circumscribed, high-signal mass in the RV cavity (arrow, A). The horizontal, long-axis, T1-weighted black-blood image showing the mass adherent to IVS (arrow, B). IVS = interventricular septum; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: An echogenic RV mass is seen on transthoracic echocardiography. The horizontal, long-axis (4-chamber view), T1-weighted, black-blood image showing a well-circumscribed, high-signal mass in the RV cavity (arrow, A). The horizontal, long-axis, T1-weighted black-blood image showing the mass adherent to IVS (arrow, B). IVS = interventricular septum; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.
Mentions: To further characterize the mass, the patient underwent cardiovascular MRI. Images revealed a homogeneous high-signal intensity within a quite irregular mass, which was adherent to the RV side of the IVS with a broad base that measured approximately 4.0 × 1.6 cm in maximal transverse diameter (Figure 3). The mass extended to the RV wall. The signal characteristics of the mass were similar to those of the thoracic muscle tissue signal on true-fast imaging with steady-state free precession (TRUFI) sequence images; thus, the lesion was suspected to be a lipoma.

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.