A case of prominent epicardial fat mimicking a tumor on echocardiography

Abstract

Epicardial fat may anteriorly produce an echo-free space that can be mistaken for pericardial fluid. We recently experienced a 67-year-old woman with prominent epicardial fat which was presented as an echogenic tumor-like mass. She underwent open pericardiostomy to relieve large amount of pericardial effusion. Operative findings revealed only prominent epicardial fat. Biopsy of the pericardial and fat tissues revealed an inflammation and normal fat cells without any malignant cell infiltration.

Intrinsic and Extrinsic Cardiac Pseudotumors: Echocardiographic Evaluation and Review of the Literature

“…Even still, the convincing appearance of both pericardial fat and pericardial effusion pseudotumors has even led to surgery for a presumed malignancy in certain isolated cases. Albeit rare, the appearance of the pericardial fat can sometimes take on an unusual form and mimic pericardial tumor deposits clinically on echocardiography . It has been postulated that this phenomenon is likely due to the concomitant presence of a small effusion surrounding the pericardial fat in a localized area and increasing the intensity of echogenicity in that area, thus creating a mass‐like effect .…”

“…Albeit rare, the appearance of the pericardial fat can sometimes take on an unusual form and mimic pericardial tumor deposits clinically on echocardiography. 40,43,44 It has been postulated that this phenomenon is likely due to the concomitant presence of a small effusion surrounding the pericardial fat in a localized area and increasing the intensity of echogenicity in that area, thus creating a mass-like effect. 40 Figure 5 shows a case of pericardial fat mimicking a pericardial tumor.…”

“…The patient underwent surgery and prominent epicardial fat with pericardial fluid was observed. *Reproduced with permission from Ahn et al…”