Intravascular Lipoma of the Superior Vena Cava

Vinnicombe, Sarah; Ag, Wilson; Morgan, Robert; Saunders, K.B.

doi:10.1097/00004728-199409000-00026

Cited by 24 publications

(16 citation statements)

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“…Some cases of a lipoma projecting into the inferior vena cava (IVC), brachiocephalic vein, femoral vein and rarely into the superior vena cava (SVC) have been described previously [1][2][3]. We report a case of intravascular lipoma of the SVC in a patient without any signs or symptoms directly correlated with the tumor.…”

Section: Discussionmentioning

confidence: 99%

Intravascular lipoma of the superior vena cava

et al. 2011

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A 63-year-old man presented to the emergency department (ED) with left-sided abdomen pain. The patient reported a 5-day history of pain under the right shoulder blade and in the lumbar region, associated with constipation, but not with vomiting, diarrhea or any change in urination. The patient was taking prescribed medications: sennonides and rifaximin that had solved the constipation, but had not completely relieved the abdominal pain. His past medical history was significant for an appendectomy many years prior. He denied having any prior medical problems or allergies. On physical examination, he was oriented, alert, comfortable and in no acute distress. The vital signs were: heart rate of 90 beats/min., blood pressure 130/80 mmHg, respiratory rate 16 breaths/min, and temperature 35.8°C. The cardiovascular and respiratory examinations were unremarkable. The abdomen was soft, but the patient had tenderness in the epigastric region and in the right hypochondrium with guarding, and a mildly positive Murphy's sign. No rebound tenderness, tenderness at McBurney's point, palpable masses or abnormal pulsations was noted. Digital rectal examination was normal. On auscultation, normal bowel sounds were heard. The genitourinary examination was normal. Laboratory analysis revealed a lipase level of 225 U/L (range 6-50 U/L), amylase level of 93 U/L (range 13-53 U/L) and blood glucose level of 146 mg/dL (range 70-110 mg/dL). The serum blood urea nitrogen, creatinine, liver function tests, albumin, electrolytes, lactate dehydrogenase level and complete blood count (CBC) were normal. Coagulation studies, including prothrombin time, activated partial thromboplastin time and serum fibrinogen, were unremarkable. A chest and abdomen radiographs and an abdominal ultrasonography were performed, but all of them were unrevealing. An electrocardiogram demonstrated rapid atrial fibrillation without any acute injury pattern. A thoracoabdominal computed tomography (CT scan) showed a superior vena caval (SVC) filling defect with a subtotal occlusion that extended into the right atrium, like the suprahepatic IVC, with a dishomogeneous aspect. A partial filling defect was also noted at the level of the portal vein, extended up to the left portal vein and the superior mesenteric vein. The interpretations suggested a significant vascular thrombosis. The CT images also revealed gastric walls' thickening. Anticoagulant therapy was started, and the patient was admitted to an internal medicine ward. Laboratory analysis was ordered to re-evaluate the CBC and the chemistry panel, to monitor the coagulation profile and the urine analysis, to perform a screening for pro-thrombotic states (with homocysteine blood level test, the protein C and protein S test and the test for anti-cardiolipin antibodies) and to control tumor markers (with PSA test and CA 19-9 and CEA tumor markers tests) on the possibility that the thrombosis was a paraneoplastic syndrome. The lipase level was 72 U/L, the gamma-glutamyltranspeptidase (GGT) level was 126 U/L (range 10-4...

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Section: Discussionmentioning

confidence: 99%

Intravascular lipoma of the superior vena cava

et al. 2011

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“…Lipomas arising within vein are rare and usually have been described in association with the involvement of inferior vena cava except that three cases [2][3][4]. Intravascular lipoma involving the superior vena cava is very rare [5,6]. We present a case of an intraluminal lipoma of the iliofemoral axis presenting as lower limb venous obstruction.…”

Section: Introductionmentioning

confidence: 99%

Intravascular lipoma from iliofemoral tract

et al. 2010

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Lipoma is a benign tumour composed of well-differentiated adipocytes and is the most common soft tissue mass. We present a case of an intraluminal lipoma of the iliofemoral axis presenting as lower limb venous obstruction. In our case, definite diagnosis is impossible as there is aspecific symptomatology and radiologic imaging methods are not able to provide diriment data, considering rarity of the disease. Therefore, we could make correct diagnosis only intraoperatively. We preferred a direct reconstruction of the wall of vein. At 12-month follow-up, we have had complete disappearance of symptoms and functional diseases.

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“…[1][2][3] There are only a few case reports describing lipomas of the superior vena cava and heart. [1][2][3][4] All of the reported lipomas of a major central vein were diagnosed with CT or, occasionally, MRI. 1,2,4,5 To the best of our knowledge, only 1 previous article described the sonographic appearance of an IVC lipoma.…”

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confidence: 99%

“…[1][2][3][4] All of the reported lipomas of a major central vein were diagnosed with CT or, occasionally, MRI. 1,2,4,5 To the best of our knowledge, only 1 previous article described the sonographic appearance of an IVC lipoma. 1 We report a case in which a lipoma of the IVC was incidentally identified on sonography and then was confirmed by CT and MRI.…”

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Sonographic appearance of lipoma of the inferior vena cava

Chou

Chiou

Tiu

et al. 2001

J of Clinical Ultrasound

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Lipomas of the major central veins are rare, and their sonographic features have rarely been reported. We report a case in which a lipoma of the inferior vena cava (IVC) was incidentally identified during liver sonography in a 68-year-old man. Sonography of the upper abdomen revealed coarsening of the liver echotexture, with a relatively small liver and atrophy of the right hepatic lobe. A 2-cm hypoechoic hepatic nodule was visualized in segment IV. Sonography also showed a 2.2- x 1.8-cm, highly echogenic, homogeneous nodule in the hepatic segment of the IVC at its junction with the right atrium. The lumen of the IVC was partially occluded. The CT and MRI appearances of the IVC lesion were consistent with a lipoma, which was not treated because there was no clinical evidence of obstruction. Histopathologic analysis following a sonographically guided biopsy of the liver nodule revealed hepatocellular carcinoma, which was treated by percutaneous ethanol injection.

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Intravascular Lipoma of the Superior Vena Cava

Cited by 24 publications

References 0 publications

Intravascular lipoma of the superior vena cava

Intravascular lipoma of the superior vena cava

Intravascular lipoma from iliofemoral tract

Sonographic appearance of lipoma of the inferior vena cava

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