Intrapericardial lipoma mimicking atrial tumour

A 64-year-old patient, attend the consultation for control of his hypertension. A transthoracic echocardiogram demonstrated an echogenic and homogeneous rounded mass with defined edges compressing the left atrium (see Supplementary dataSupplementary data online, Movies S1 and S2). The size of the mass was 60 × 50 mm (A). Colour flow mapping ruled out intracardiac obstruction (see Supplementary dataSupplementary data online, Movie S3). Left ventricular ejection fraction was normal (65%). Multi-detector computed tomography revealed the extracardiac and intrapericardial origin of the mass. The density of the mass was equal to that subcutaneous adipose tissue (Hounsfield measurement −50 HU) compatible with intrapericardial lipoma (B). Lipomas, a tumour composed of mature fat, represents the third most frequent benign cardiac tumour, after myxoma and papillary fibroelastoma. Half of the lipomas are located in the subendocardium and the remaining 25% in the myocardium and 25% in the subepicardium. They occur at any age and with the same frequency in both sexes, as single and encapsulated nodular masses. They are usually underdiagnosed as they usually develop asymptomatically and are generally diagnosed as a finding in routine studies, so their actual incidence is not known. We present a case of an extracardiac mass diagnosed with echocardiography. CT revealed its intrapericardial location and fat content. The tumour was not excised because it did not cause symptoms. This case demonstrates a rare but easy-to-handle differential diagnosis that should be considered when patients present with a cardiac mass.

from #AlexandrosSfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2q2czRl
via IFTTT