Intrapericardial Giant Lipoma Displacing the Heart

Abstract

Despite their benign character, intrapericardial lipomas can cause life-threatening complications by rapid growth. This paper presents a case of an intrapericardial lipoma in an almost asymptomatic 41-year-old female patient only suffering from mild dyspnoea on exertion. The tumour was found incidentally by chest X-ray. Echocardiographic examination and a CT scan of the thorax revealed a 16 × 14 × 12 cm lipomatous tumour mass highly suspective of a lipoma. Histological examination of excised tumour specimens confirmed the diagnosis of a lipoma. The patient is currently asymptomatic and has not presented with evidence of recurrence at the 6-month followup.

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

“…The etiology of cardiac lipomas remains undetermined. They are benign tumours of the heart that are mainly composed of mature adipocytes without any cellular atypia (Figures 3 and 4) [1–4]. They are usually well-encapsulated masses [1, 3].…”

“…They are usually well-encapsulated masses [1, 3]. Grossly, they appear as yellow fat divided by fine fibrous trabeculae [4]. The capsule is a major differentiation point between cardiac lipoma and lipomatous hypertrophy.…”

“…When intracardiac, they are most commonly found in the right atrium and the left ventricle but can be seen in almost any other location of the heart [1, 4]. They usually have a broad base or peduncle of attachment and are less mobile compared to other benign tumours of the heart [4, 6]. …”

“…Most cardiac lipomas do not cause symptoms or they may remain asymptomatic for a long time [1, 4]. They mas cause arrythmias, or symptoms due to invasion or mass effect [1, 2].…”

“…Most cardiac lipomas remain small and do not cause symptoms, or if they do, they may remain asymptomatic for a long while [1, 4]. However, like the case here demonstrates, at times they can grow large and cause significant symptoms.…”