Right atrial lipoma

Abstract

Primary cardiac tumors are rare, not easily clinically diagnosed, and differ in regard to clinical manifestations, location, morphology, size, and radiological findings 1 .The incidence of primary tumors of the heart and pericardium ranges from 0.02% to 0.28%, according to a series of autopsies reported by McAllister HA Jr 2 . On the other hand, neoplasias, mainly mammary and pulmonary neoplasias (that send more metastases to the heart), followed by leukemias and lymphomas are 10 to 40 times more frequent than primary cardiac tumors. Cardiac metastases are found in the autopsies of 10% of the patients who die from pulmonary cancer and of 25% of those with tumors in other organs. In children, cardiac tumors are rare, not exceeding 10% of all neoplasias in this age bracket 3 .Approximately 75% of the primary cardiac tumors are benign 4 , myxomas being the most common, followed by rhabdomyomas, lipomas, fibromas, and teratomas 3 . Cardiac lipomas, initially reported by Orth in 1886 5 , account for 8.4% of the primary tumors of the heart and pericardium. Until 1990, 63 had been reported 6 . According to the available literature, 25% of cardiac lipomas are intramyocardial, 25% are extracavitary of epicardial origin, and 50% are intracavitary of subendocardial origin -those of the right atrium are extremely rare 7 .In the recent literature, a case of intrapericardial lipoma in a 27-year-old female 8 and a case of right atrial lipoma in a 54-year-old male have been reported 9 . In 1994, Diamante et al 10 reported a peculiar case of epicardial lipoma that caused inversion of the left atrial auricle and partial obstruction of the drainage of the left pulmonary veins, leading to pulmonary and systemic arterial hypertension, cardiomegaly, and electrocardiographic changes. In a study of 50 cases of primary cardiac neoplasias by Fernandes et al 11 , only 1 lipoma was reported. Case ReportThe patient was a 48-year-old male who complained of high blood pressure and epistaxis for 2 months. He denied similar previous episodes. He also reported being an exsmoker (2 packs per day) for 20 years and denied alcoholism. His personal and familial antecedents were not relevant.At the time of the symptoms, the patient visited a cardiologist. Due to the nonspecificity of the symptoms, an echocardiography (7/2/98) was performed and revealed a right atrial tumor of 4.6x3.5 cm with characteristics of adipose tissue.The patient was referred to our service. On physical examination, he was in good general condition, eupneic, acyanotic, and had no fever. His blood pressure was 130/ 80mmHg, his heart rate was 60 bpm, and the rest of his physical examination was within the normal range.The laboratory tests showed a mild leukocytosis (13,900 cells/mm 3 ) with no deviation to the left. The remaining tests were within the normal range.The chest X-ray showed normal pulmonary transparency, normal hila, free diaphragmatic sinuses and cupula, and a normal cardiac image.The electrocardiography detected sinus rhythm of 72 bpm with deviation of the cardiac ...

Eleven-Year Experience in Diagnosis and Surgical Therapy of Right Atrial Masses

“…According to the relation between mass and tricuspid valve, symptoms of right heart failure, arrhythmias, syncope, or ischemic sign and symptoms stemming from right coronary artery occlusion have been reported 9,10 . It has been reported that primary cardiac tumors can be responsible for 0.0025% of the sudden cardiac deaths due to destruction of conduction system 11 . None of our patients had sudden cardiac death or conduction disease.…”

“…9,10 It has been reported that primary cardiac tumors can be responsible for 0.0025% of the sudden cardiac deaths due to destruction of conduction system. 11 None of our patients had sudden cardiac death or conduction disease.…”

Anterior Thalamic Infarction as Initial Manifestation of a Right Atrial Lipoma

“…[2][3][4] Lipomas are benign nonmyxomatous neoplasms of the heart that normally cause no symptoms and their diagnosis is often accidental. [5][6][7] They represent 10% of the overall cardiac tumor masses arising from cardiac tissue and they are most frequently located in the right atrium. 8 The relationship of cardiac lipomas with stroke is not well established, probably because of the rarity of this type of tumors.…”

Primary Cardiac Lipoma in a Dog

“…4,6 Independent of their origin, myocardial lipomas are seldom associated with clinical symptoms and are therefore found accidentally. 7,8 The patients may remain asymptomatic for a long time and the lipoma may reach very large dimensions. On rare occasions, lipomas may induce arrhythmias or may interfere with myocardial contraction; sudden death is a rare occurrence.…”

“…On rare occasions, lipomas may induce arrhythmias or may interfere with myocardial contraction; sudden death is a rare occurrence. [4][5][6][7][8][9] Lipomas located close to the cardiac valves may lead to an audible murmur or early symptoms because of the presence of obstructions. 6 In some cases, the tumor can interfere with cardiac filling and emptying.…”