Lipomatous interatrial septal hypertrophy: an unusual cause of intracardiac mass

Abstract

Lipomatous hypertrophy of the interatrial septum is an uncommon entity that usually occurs in elderly patients. We report a patient who presented with atrial fibrillation, congestive cardiac failure and a large intracavitary mass in the right atrium on echocardiography. He underwent successful resection of the mass with septal reconstruction. Pathology was consistent with lipomatous hypertrophy of the interatrial septum.

Fatty lesions of the atria and interatrial septum

“…Complete resection may not be possible because the lesion is not encapsulated and diffusely infiltrates the septal wall. Obstruction of the superior caval vein has been described in a number of reports [10,11,29]; however, recurrence after excision has not been reported and, as mentioned, the rate of malignant transformation is exceedingly rare. The surgical approach to lipomas is similar to the surgical approach to LHIS and is dependent on the size and location of the lesion, as well as the patient's symptoms.…”

“…Indications for surgery of any lipomatous interatrial or septal lesion may include intractable arrhythmias, valvular dysfunction, inflow or outflow obstruction to blood, thromboembolic sequelae, and an inability to confidently exclude liposarcomas [9][10][11]19,[29][30][31]. Lipomatous hypertrophy of the interatrial septum may require resection of a portion of the IAS and free atrial wall, necessitating repair with an autologous pericardium or a Dacron patch [10].…”

Lipomatous Hypertrophy of the Atrial Septum in a Patient Undergoing Coronary Artery Bypass Surgery

“…LHAS is rare [14, 15]. Since its first description in a series of five autopsy cases by Pior in 1964 [16], less than 300 cases have been reported [13, 17].…”

Lipomatous hypertrophy of the interatrial septum and fibrosing mediastinal lymphadenopathy causing superior vena cava obstruction

“…Surgical resection has been performed in symptomatic patients with SVC obstruction or with intractable arrhythmias. [ 1 2 3 ] It differs from a pure lipoma in that lipomas are true neoplasms and usually occur in a much younger patients. However, surgical treatment is similar for both.…”

“…[ 1 2 ] Although many theories have been suggested, etiology of LHIS is still unknown. [ 3 4 ] Fibrosing mediastinal lymphadenopathy due to tuberculosis (TB) is a rare cause of SVCS. [ 5 ]…”