Infiltrating Lipoma of the Right Ventricle Involving the Interventricular Septum and Tricuspid Valve

Abstract

Cardiac lipoma, which are primary cardiac tumors, are rare entities often detected incidentally during imaging. There have been very few reports on the right ventricle (RV) lipoma. Here, we present a case of RV infiltrating lipoma involving the interventricular septum (IVS) and the tricuspid valve. Clinical symptoms, diagnostic procedures, multimodality imaging characteristics, and treatment are discussed, and the complete clinical data of this case and relevant details of retrospective literature are reviewed. The study described the case of a 48-year-old woman who suffered from occasional palpitation after exertion for 10 years. Imaging examinations, including echocardiography and cardiovascular magnetic resonance imaging (MRI), revealed a large mass adherent to the IVS and the right ventricular wall that was consistent with lipoma. The patient underwent surgical repair of the tricuspid valve and excision of the partial mass. The gross specimen revealed piles of 5 × 4 × 3 cm fragments with yellowish appearance and pathological results showed infiltrating lipoma.Lipoma is often asymptomatic and diagnosed incidentally. Surgical excision is the main therapeutic intervention, which is always performed in cases of symptomatic lipoma or when malignancy is suspected. Multimodality imaging would be great help in the diagnosis of cardiac lipoma. Echocardiography is a convenient method for follow-up.

Tale of fat and fib — cardiac lipoma managed with radiofrequency ablation: A case report

“…Lipomas are benign encapsulated fatty lesions with unclear etiologies[ 1 ]. A study done by Italiano et al[ 9 ] showed that solitary lipoma is associated with chromosome 12 gene rearrangements, where an abnormality in HMGA2-LPP fusion gene was noted.…”

“…LHIS, although has fatty deposits, it is a separate entity from lipoma with variable pathology[ 1 ]. Heyer et al[ 14 ] showed an LHIS incidence of 2.2% by multi-slice CT. Higher prevalence of LHIS has been observed in patients with advanced age, atrial arrhythmias, obesity.…”

“…Cardiac lipomas constitute approximately 10% of benign cardiac tumors. They are most commonly noted in interatrial septum (IAS) followed by the right atrium and left ventricle[ 1 ]. Lipomas involving the IAS should be differentiated from lipomatous hypertrophy of interatrial septum (LHIS) as they both have similar features on imaging except for the characteristic sparing of fossa ovalis in LHIS.…”

Surgical resection of a cardiac lipoma of the right ventricle

“…TEE also confers the benefit of detecting small masses or unclear cardiac structures, especially when a transthoracic echocardiogram is suboptimal. [5]…”

“…[3] The right ventricle (RV) represents a very unusual location for cardiac lipomas with only a handful of these cases presented in the literature. [245] Herein, we report a case of a primary intracardiac lipoma of the RV which was attached to the interventricular septum (IVS).…”