A case of giant left ventricular lipoma: unusual presentation

Abstract

Primary cardiac tumors are rare and usually benign. The incidence of cardiac lipomas is 8 % of benign cardiac tumors [1]. Several surgical options have been reported to obtain an appropriate operative view because of their poor visualization when the tumors are located in the Left Ventricle (LV). We report a rare case of massive left ventricular lipoma occupying pericardial space. A 23-year-old female had back pain since 6 months. She visited a local orthopedician, who ordered for computed tomography scan of chest and back. Computed tomography showed a large epicardial mass located along the anterior surface of the heart, from the diaphragm level through the aortic arch level. The mass showed an attenuation value identical with that of subcutaneous adipose tissue and contained some areas with high density. The mass was not enhanced by contrast media. Percutaneous biopsy was done, histologic examination of the specimen demonstrated mature adipose tissue. An encapsulated adipose mass weighing 865 g, which originated from the left ventricle anteriorolateral surface without any invasion to the pericardium, was near completely excised, except for a small portion which was encasing obtuse marginal artery. Microscopic examination revealed mature adipose tissue with partial necrosis, confirming the diagnosis of lipoma.