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

Abstract

BackgroundCardiac 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 presentationHere 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.ConclusionsThe patient ultimately underwent complete tumor resection with uneventful postoperative evolution. The postoperative pathological diagnosis is cardiac lipoma.

Cardiac Lipoma: An Uncharacteristically Large Intra-Atrial Mass Causing Symptoms

“…Cardiac lipomas are rare, benign tumours that usually remain small, asymptomatic, and are found incidentally on autopsy [1, 2]. This is a rare case where the tumour was large and was determined to be causing significant symptoms.…”

“…The capsule is a major differentiation point between cardiac lipoma and lipomatous hypertrophy. The latter is usually an asymptomatic continuation of the epicardial fat, and when arising from the interatrial septum, it usually spares the fossa ovalis [2]. Unlike, cardiac lipomas which do not have any clear associations, lipomatous hypertrophy is seen more commonly in older, obese people and in females [3].…”

“…They mas cause arrythmias, or symptoms due to invasion or mass effect [1, 2]. They can cause a whole spectrum of symptoms depending on their size and location including dyspnea, chest pain, arrhythmias, syncope, and stroke-like symptoms [2].…”

“…They mas cause arrythmias, or symptoms due to invasion or mass effect [1, 2]. They can cause a whole spectrum of symptoms depending on their size and location including dyspnea, chest pain, arrhythmias, syncope, and stroke-like symptoms [2]. The mechanisms driving these symptoms include direct obstruction of intracardiac blood flow, dysfunction of cardiac valves, obstruction of the superior and inferior vena cava, and even phrenic nerve involvement [4].…”

“…Different autopsy series estimate the incidence to be anywhere from 0.001 to 0.19% [1, 2]. Cardiac lipomas comprise approximately 10–19% of all primary tumours of the heart and pericardium and make up 8.4% of all the benign ones [2, 3]. …”