Multiple well‑differentiated cardiac liposarcoma with a concomitant myocardial lipoma: A case report

Kong, Fanlei; Zhang, Wei; Guo, Qiyong

doi:10.3892/mco.2018.1741

Cited by 10 publications

(12 citation statements)

References 14 publications

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“…It cannot be distinguished from primary malignant cardiac lesions such as liposarcoma based on clinical presentation or non- invasive diagnostic modalities. Cardiac liposarcomas are aggressive malignant mesenchymal neoplasms which carry poor prognosis and hence represent important differentials to be ruled out [6]. Intra-cavitary lipomas usually present as homogenous hyperechoic masses on echocardiography however these findings are not diagnostic and hence cannot be utilised to conclusively distinguish cardiac lipomas from cardiac liposarcomas [7].…”

Section: Resultsmentioning

confidence: 99%

Right atrial and SVC infiltrating mass-the entity of infiltrating lipoma

Shah

Badran

Kaarne

et al. 2019

J Cardiothorac Surg

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BackgroundCardiac lipomas are rare benign primary cardiac tumours primarily composed of mature adipocytes. They are usually well defined, encapsulated masses, but rarely demonstrate malignant characteristics by infiltrating the myocardium. This causes diagnostic uncertainty as it becomes a priority to rule out primary malignant cardiac tumours such as sarcoma which often carry a poor prognosis.Case ReportA 61 year old female presenting with chest pain was found to have an infiltrating right atrial hypertrophic mass. Mutli-disciplinary team (MDT) discussions along with the presence of symptoms and likelihood of malignancy led to the recommendations for surgery.Intraoperatively this involved the right pulmonary veins and superior vena cava (SVC). The mass was resected with good margins and reconstruction of the right atrium, pulmonary veins and SVC was done using porcine pericardial patch. The patient made a good postoperative recovery and was discharged home in sinus rhythm with no significant valvular lesions. This was further confirmed at 6 month follow up. Final histology was that of infiltrating lipoma.ConclusionsIn this rare case of infiltrating cardiac lipoma in a relatively young patient, the diagnostic uncertainty despite multimodal imaging meant surgery was indicated due to the high suspicion of cancer. Even in benign cases, fatty infiltration can lead to conduction defects and embolisation. Technical difficulties in sectioning these specimens is caused by intra-tumour variability and current recommendations are for excision biopsy, for best characterisation.The management of these patients requires an MDT with Cardiac surgery being a safe approach providing definitive management.

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Section: Resultsmentioning

confidence: 99%

Right atrial and SVC infiltrating mass-the entity of infiltrating lipoma

Shah

Badran

Kaarne

et al. 2019

J Cardiothorac Surg

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“…However, the differentiation between mature cardiac lipomas and well-differentiated liposarcomas may be di cult by imaging 29 . The information extracted from radiomics may be of value in differentiating between two closely related entities 30 .…”

Section: Discussionmentioning

confidence: 99%

The Value of Multimodality Imaging in Diagnosis and Treatment of Cardiac Lipoma

Shu

Yuan

Kong

et al. 2021

Preprint

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Background: Cardiac lipoma is a rare primary tumor in the heart and pericardium. Multimodality imaging methods, especially magnetic resonance imaging (MRI), are crucial in detecting and diagnosing cardiac lipomas. Besides, they are of significant importance in management of cardiac lipomas. The aim of this study was to evaluate the value of multimodality imaging methods in diagnosing and treatment of cardiac lipoma by describing a series of cases of cardiac lipoma.Materials and Methods: Data of patients with cardiac lipoma at a local institution were retrospectively collected. Their imaging findings on echocardiography, computed tomography (CT), and cardiac MRI and clinical management were described in detail. Results: 12 patients with cardiac lipoma were retrospectively included with thirteen lipomas found within heart and pericardium. Two patients’ lipoma were symptomatic, while lipomas in other 10 patients were found incidentally. Most lipomas were sensitively detected with echocardiography. Accurate diagnoses were achieved with CT and MRI in all cases. Surgical resection was performed in one symptomatic patient due to the obstruction of the left ventricular outflow tract, while the removal of pericardial lipoma in another symptomatic patient was not possible due to diffuse myocardial infiltration observed in MRI. Based on MRI findings, two patients without clinical symptoms also underwent surgery to prevent the risk of detachment of ventricular lipoma with a narrow pedicle in one patient and potential further thinning of the myocardium by pericardial lipoma growth in another patient. Conclusions: Cardiac lipoma could be sensitively detected and accurately diagnosed with multiple noninvasive imaging tools. Comprehensive evaluation with multimodality imaging methods should also be conducted for better management planning and follow-up in all patients.

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“…The infiltrative growth pattern has been postulated as the result of gradual invagination of the firm lipomas into the pliable cavity wall within the process of repetitive systolic contraction [ 20 ]. No evidence is available that cardiac lipomas may undergo malignant transformation, but mature lipomas and well-differentiated liposarcomas may coexist within one heart [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…For lipomas within cardiac cavities, obstruction of blood flow may cause symptoms varying from fatigue to even syncope [ 32 – 34 ]. Large pericardial lipomas can be symptomatic by compressing cardiac chambers, vessels or coronary arteries [ 21 , 35 , 36 ]. Myocaridal lipomas are prone to cause conduction abnormalities by compression or infiltration of the conduction system [ 37 , 38 ].…”

Section: Introductionmentioning

confidence: 99%

“…The presence of nonuniformly thick septa and mass-like nonadipose areas may suggest the diagnosis of liposarcoma [ 58 ]. The differentiation between mature cardiac lipomas and well-differentiated liposarcoma may occasionally be difficult by imaging [ 21 ]. In summary, echocardiography plays an irreplaceable role in screening of cardiac lipoma, while CT and MRI (particularly MRI), is indispensable for accurate diagnosis and comprehensive evaluation.…”

Section: Introductionmentioning

confidence: 99%

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From pathogenesis to treatment, a systemic review of cardiac lipoma

Shu

Wang

Zheng

2021

J Cardiothorac Surg

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Cardiac lipoma is an uncommon primary cardiac tumor. With the advancement of diagnostic methods and treatment techniques, more cases of cardiac lipomas have been reported and suggest that the entity previously widely thought to display classic features may also show atypical findings. A systemic review of the rare cardiac tumor was done by searching the literature of cardiac lipoma. We endeavor to summarize the clinical features of the rare disease from pathogenesis to treatment. Literature of cardiac lipoma was retrospectively searched through PubMed and 255 cases of cardiac lipoma were included into this analysis. Cardiac lipomas can occur anywhere within the heart, 53.1% were located within the cardiac chambers, 32.5% in the pericardium, 10,7% within the myocardium and 3.7% involved multiple structures. More than half of the reported cardiac lipomas (66%) may be clinically symptomatic, presenting with symptoms ranging from chest discomfort to syncope depending on their size and location as well as extent of myocardial involvement. Noninvasive cardiac imaging has replaced the role of autopsy and cardiothoracic surgery in detection and diagnosis of cardiac lipomas. Most symptomatic patients (83.7%) were treated by resection of cardiac lipomas and 68.3% of asymptomatic patients also underwentprophylactic resection. Overgrowth and myocardial infiltration of lipomas may result in unsuccessful resection. Recurrence of cardiac lipomas was rare but reported in a few cases. The early detection and accurate diagnosis of cardiac lipoma is of great significance in clinical management, to avoid an unfavourable outcome due to overgrowth.

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Multiple well‑differentiated cardiac liposarcoma with a concomitant myocardial lipoma: A case report

Cited by 10 publications

References 14 publications

Right atrial and SVC infiltrating mass-the entity of infiltrating lipoma

Right atrial and SVC infiltrating mass-the entity of infiltrating lipoma

The Value of Multimodality Imaging in Diagnosis and Treatment of Cardiac Lipoma

From pathogenesis to treatment, a systemic review of cardiac lipoma

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