Excess Epicardial Fat Mimicking a Pericardial Tumor in a Patient with Pericardial Effusion

Abstract

A mass-like lesion in the posterior atrioventricular groove and moderate pericardial effusion were incidentally observed during evaluation of fever in a woman in her 80s. Initially, a pericardial tumor was suspected. However, computed tomography revealed no mass lesions. Instead, low-density lesions were observed in the atrioventricular groove, interventricular groove, and around the great arteries, consistent with excess epicardial fat. Tissue characterization by computed tomography and the typical distribution consistent with fat deposits were key in diagnosis. Physicians should be aware that excess epicardial fat may be mistaken as a pericardial tumor, especially in the presence of pericardial effusion.