Left Atrial Appendage Lipoma: An Unusual Location of Cardiac Lipomas

Abstract

Cardiac lipomas are benign neoplasms of the heart and accounts for 8.4% of all primary tumors. They can occur sporadically at any age with no sex preference. The tumor originates mostly in the subendocardium and subepicardium but very rarely within the myocardium. Clinically this tumor is asymptomatic and found incidentally in the vast majority of cases. On occasion large lesions can lead to mechanical obstruction and pericardial effusions if located in the epicardium. Although lipomas can occur at different atrial or ventricular locations, it was never reported at the level of the left atrial appendage (LAA). Usually a mass in the LAA represents a thrombus, however there are few case reports of LAA tumors mainly representing fibroelastomas, myxomas, hemangiomas, and malignant tumors. To our knowledge there are no reported cases of left atrial appendage lipomas (LAAL) in the medical literature. We report the first case of LAAL discovered incidentally on transesophageal echocardiogram during off pump coronary artery bypass grafting.

Cardiac Lipoma at Unusual Location – Mimicking Atrial Myxoma

“…The most common chambers affected are the left ventricle and the right atrium. Rarely, it has been reported to be seen in left atrial appendage also . The invasion of interatrial septum, as in our case, represents an unusual location.…”

“…Rarely, it has been reported to be seen in left atrial appendage also. 8 The invasion of interatrial septum, as in our case, represents an unusual location. Cardiac lipomas have no sex or age preference and are extremely variable in size.…”

Multiple well‑differentiated cardiac liposarcoma with a concomitant myocardial lipoma: A case report

“…The incidence of primary cardiac lipomas is only 0.17–0.19% based on autopsy reports ( 3 ). Cardiac lipomas account for 8.4% of all primary cardiac tumours; they have no gender or age predominance ( 4 ) and they vary significantly in size ( 3 ). Most cardiac lipomas arise from the endocardium or the epicardium, while very few develop in the myocardial layer.…”

“…Most cardiac lipomas arise from the endocardium or the epicardium, while very few develop in the myocardial layer. Although there have been reports of cardiac lipomas developing in both the atria and the ventricles, they generally tend to develop in the right atrium ( 4 ).…”

A large left atrial lipoma combined with coronary artery disease

“…Cardiac lipomas are extremely rare, accounting for 8.4% of all primary tumors [ 1 ]and found at a frequency of only 0.001%–0.28% at autopsy [ 2 ]. They are frequently located in the left ventricle or right atrium.…”