Diagnosis of a myocardial lipoma by using CT

Abstract

Cardiac lipomas are rare benign primary tumors of the heart [1]. We describe a case in which the preoperative diagnosis was made by using CT. Case ReportA 28-year-old man was referred for evaluation of ventricular tachycardia, which had been diagnosed after an episode of syncope. When the patient was i 0 years old, he was told he had an enlarged heart, and he underwent a cardiac catheterization at that time, details of which are not available.Physical examination was normal. A chest radiograph showed an enlarged heart (Fig. iA). An initial two-dimensional echocardiogram showed normal ventricular size and function. The distal aspect of the ventricular septum had abnormal motion. Cardiac catheterization showed normal right and left ventricular function. The left anterior descending coronary artery was displaced anteriorly by an epicardial mass, which also stretched the septal perforators. A second echocardiogram showed an echogenic mass external to the heart that extended from the anterior intraventricular groove circumferentially to the inferior posterior wall.To evaluate the mass further, both noncontrast CT and dynamic CT during a 100-mI bolus injection of 61 % iopamidol were performed.Scans showed a large, low-density mass located along the left side of the heart, beginning at the anterior intraventricular groove and extending posteriorly to the left atrium. The mass covered the entire anterior wall and most of the lateral wall of the left ventricle. The density of the mass was -1 07 H. No contrast enhancement of the mass was seen. The left anterior descending coronary artery and smaller branch vessels were displaced away from the ventricular wall by the mass (Figs.

Primary Cardiac and Pericardial Neoplasms: Radiologic-Pathologic Correlation

“…Most reported cases of cardiac lipomas are described as single lesions; however, multiple lipomas have been reported in patients with congenital heart defects, tuberous sclerosis, and rarely in an otherwise normal heart (1,68,70). Radiologic Features.-The most frequent radiographic abnormality in patients with cardiac lipoma is cardiomegaly (68,70,71). A globularshaped heart has also been described (69).…”

Pericardial lipoma in a geriatric dog with an incidentally discovered thoracic mass

“…The lesion contour is typically smooth (Zingas and others 1983, Hananouchi and Goff 1990). Although these tumours do not demonstrate contrast enhancement, the use of intravenous contrast material may increase the conspicuity of masses on CT (Conces and others 1989).…”

CT and MR Imaging of Primary Cardiac Malignancies

“…CT provides better soft-tissue contrast than echocardiography, can depict calcification and fat, and may allow tissue diagnosis of some masses such as lipomas (4). Although spatial resolution of CT has improved with the development of faster imaging techniques, particularly electron beam CT, this modality is still far inferior to echocardiography in the depiction of small moving structures such as the cardiac valves.…”