Unusual Location of a Posterior Lipoma Originating From the Left Atrial Roof: Case Report and Review of the Literature
Lipomas are the most common type of soft tissue tumors. They mainly are located in subcutaneous tissue in the body, including the heart. The cardiac location of lipomas is rare, mostly asymptomatic, and can cause life-threatening complications by rapid growth. The clinical symptoms, when present, occur in evolution with the growth in size, depending upon the location and degree of invasion in the endocardium.
We present the case of a 63-year-old male patient with a large intrapericardial lipoma with an unusual location, originating from the left atrial roof. The initial symptoms of the patient were shortness of breath, dizziness, and mild dyspnea. Transthoracic echocardiography (TTE) was the first line diagnosis method, followed by computed tomography (CT); both showed a large posterior intrapericardial mass. Resection of a 12/8/5 cm lipomatous tumor mass was performed via median sternotomy, under cardiopulmonary bypass (CPB) on the beating heart. Histopathologic examination revealed the presence of diffuse proliferation of large- and medium-sized mature adipocytes consistent with the diagnosis of pericardial lipoma. The patient was discharged at home on the seventh postoperative day, with a marked improvement of his clinical state and effort tolerance. He did not present evidence of recurrence at his 1-year follow up.
Da Silva, De Campos AMF, Vieira Baldo RC, et al. 2017. Pericardial lipoma: Diagnosed unexpectedly during heart failure investigation – Case Report. Curr Res Cardiol 4(4):55-57.
Dorobantu LF, Stiru O, Prodea A, et al. 2011. Unique case of primary malignant fibrous histiocytoma of the right ventricle with moderator band involvement. Heart Surg Forum 14(4):E245–E248.
Fine G. 1968. Neoplasms of the pericardium and heart. In: Gould SE, editor. Pathology of the Heart and Blood Vessels, 3rd. Springfield: Charles C. Thomas. 865.
Heath D. 1968. Pathology of cardiac tumors The American Journal of Cardiology 21(3):315-327.
Iliescu VA, Dorobantu LF, Stiru O, et al. 2008. Second recurrence of cardiac myxoma 7 years after the initial operation. Chirurgia 103(2):239-241.
Italiano A, Ebran N, Attias R, et al. 2008. NFIB rearrangement in superficial, retroperitoneal, and colonic lipomas with aberrations involving chromosome band 9p22. Genes Chromosomes Cancer 47(11):971-7.
McAllister, Hall RJ, Cooley DA. 1999. Tumors of the heart and pericardium. Curr Probl Cardiol 24(2):57-116.
McAllister HA, Fenoglio JJ. 1978. Tumors of the cardiovascular system atlas of tumor pathology. 2nd series. Fascicle 15. Washington DC: Armed Forces Institute of Pathology 52-8.
Mourad OMA, Andrade FM, Abrahao P. et al. 2009. Massa mediastinal gigante assintomática: um raro caso de timolipoma. J Bras Pneumol 35(10):1049-52.
Noly PE, Mongeon FP, Rochon A, et al. 2016. Pericardial Constriction Caused by a Giant Lipoma Circulation 133:1709-1712.
Steger C. M. 2011. Intrapericardial giant lipoma displacing the heart. ISRN cardiology. 243637.
Valencia A, Lombo M, Correa J. 2011. Lipoma intrapericárdico gigante silente. Rev Colomb Cir 26:222-5.
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