Pericardial lipoma: Ultrasound, computed tomography and magnetic resonance imaging findings

Abstract

Primary tumours of the heart and pericardium are extremely rare. Cardiac lipomas account for only 10% of all primary cardiac tumours. A case of surgically proven pericardial lipoma demonstrated by ultrasound, CT and MRI is presented here.

Pericardial lipoma: Diagnosed unexpectedly during heart failure investigation- Case Report

“…Typically, lipomas are asymptomatic however, when symptoms are present they vary depending on the location and mass size (1)(2)(3)(4)(5)(6)(7)(8). The main clinical findings are associated with mechanical compression (7-9) and include cough, angina, malaise, palpitations and arrhythmias, atrioventricular block, precordialgia, fatigue, dyspnea, syncope and even sudden death (7,9,10).…”

“…Lipomas account for 8.4% to 10% of the cases of primary heart neoplasms and approximately 14% of benign cardiac masses (1,4).…”

Multiple cardiac lipomas and pericardial lipomatosis: Multidedector-row computer tomography findings

“…Cardiac lipomas are encapsulated true neoplasms, composed of mature adipose tissue [3]. Lipomas can originate in subendocard, subepicard or myocard with an incidence of 50, 25 and 25%, respectively [1,4]. The most common sites for lipomas are reported to be right atrium, left ventricle and interatrial septum [5].…”

“…In rare instances, depending on their size, location and mobility lipomas can display symptoms [7]. Symptoms such as (i) alteration of ventricular function, cardiac insufficiency, congestive heart failure secondary to mass effect of large lipomas, (ii) valvular obstruction or insufficiency, (iii) ventricular dysrhytmies with intramyocardial lipomas, (iv) obstruction of intracardiac blood flow with dimensionally great lipomas, (v) systemic or pulmonary embolism, (vi) angina, syncope and sudden death are all mentioned in the literature [4,[7][8][9][10]. In our case, the constrictive effect of the extensive pericardial fatty accumulation is postulated to be the cause of pleural effusion secondary to left heart failure.…”

“…With MDCT, in different imaging planes, the exact site and extension of lipomas can be detected on the basis of their densities similar to that of fat attenuation (<0 HU) and distinguished from myxoma and trombus which have higher attenuation (>0 HU) [2,4]. Liposarcoma can be excluded in the differential diagnosis of lipomas because even a well-differentiated liposarcoma has a higher CT HU number [4].…”