Giant intrapericardial lipoma: Clinical and forensic implications

Abstract

Introduction. Even though lipomas are the most common benign tumors, they are rarely found in the pericardial cavity. Although histopathological benign, they can cause lifethreatening complications by rapid growth and, therefore, clinically may be considered as malignant. Case report. We present a case of an 80-year-old female who was injured during syncopial episode, when falling from standing height and later died in the hospital without an obvious cause of death. At the autopsy, a dilated and tense pericardium filling up a large part of the chest cavity was noted. A well-encapsulated soft tissue mass, 20x18x3cm in size and measuring 820 g, was visualized in the pericardial cavity. Histopathological examination revealed that the mass was lipoma and showed acute myocardial necrosis and, therefore, it was assumed that the cause of death was myocardial infarction, probably due to the compression of lipoma on coronary arteries. Conclusion. Even though intrapericardial lipomas are benign tumors, they can cause life-threatening complications and sudden cardiac death. There are numerous diagnostic methods capable of detecting intrapericardial lipomas, and with timely treatment patient can be cured.