Sonographic appearance of lipoma of the inferior vena cava

Abstract

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.

Mobile primary renal vein lipoma with an accelerated growth pattern

“…Conservative management is the standard care for centrally located primary intravascular lipomas, with surgical resection only indicated for symptomatic cases. 10 Most large and symptomatic tumors were surgically removed with limited complications. 4 , 11 , 12 The commonly reported symptoms included swelling and dyspnea.…”

“Lipoma” of the inferior vena cava is actually a pericaval fat collection

“…1 The authors nicely document the presence of a collection of fat related to the intrahepatic inferior vena cava (IVC) on sonography. 1 However, we would like to add the following information.…”

“…1 The authors nicely document the presence of a collection of fat related to the intrahepatic inferior vena cava (IVC) on sonography. 1 However, we would like to add the following information. As shown by several groups, including our own, this``lipoma'' is not fat within the IVC but is actually a collection of fat that is adjacent to but not within the lumen of the intrahepatic IVC.…”