Lipomatous Hypertrophy Of The Interatrial Septum Research Articles

Lipomatous Interatrial Septum Detected During Cardioversion Evaluation for Atrial Fibrillation

Primary cardiac tumors are rare, with an estimated prevalence in autopsy series ranging from 0,001 to 0,28%. Benign tumors are the most common type, with lipoma being the second most frequent among these, following myxoma. Lipoma can pose a differential diagnostic problem with lipomatous hypertrophy of the interatrial septum (IAS). This entity is rare and often asymptomatic, requiring no surgical treatment unless it causes obstruction of surrounding anatomical structures. In practice, cardiac CT and MRI are frequently used to confirm echocardiographic suspicions, both transthoracic and transesophageal. We present the case of a 72-year-old patient referred for management of recent atrial fibrillation, with heart rate control proving difficult despite maximum dose medical treatment. We opted for electrical cardioversion to improve the patient's hemodynamic state in the short term and to prevent progression to atrial cardiomyopathy in the medium and long term. In the transesophageal echocardiogram (TEE), the patient exhibited significant thickening of the interatrial septum, measuring 22 mm, without compression of the superior vena cava, and with the fossa ovalis remaining intact. Through this case, we discuss the diagnostic and therapeutic approaches to lipomatous hypertrophy of the IAS.

Abstract 14390: Interatrial Block in the Presence of Lipomatous Hypertrophy of the Interatrial Septum

Introduction: Interatrial block (IAB) from disruption of conduction through Bachmann’s bundle results in atrial electromechanical dysfunction. Delay in conduction and alteration in the pattern of atrial activation causes P-wave lengthening (≥120 ms) and characteristic biphasic P-waves in the inferior ECG leads. IAB has been associated with atrial arrhythmia and risk of stroke. Generally, the anatomic substrate for IAB is a fibrotic atrial myopathy; however, intertrial masses have also been associated with IAB. Lipomatous hypertrophy of the interatrial septum (LHIS) constitutes an anatomical barrier that could similarly lead to IAB. Hypothesis: The presence of LHIS is associated with an increased prevalence of IAB. Methods: A query of the echocardiography database at our institution from 2017 to present revealed 312 subjects with LHIS. Data collection included demographic characteristics, ECG and echocardiographic parameters. Prevalence of IAB and associated clinical variables were assessed. Results: The mean age was 72 years (56% male). In the total group IAB was present in 131 patients (42%). Comparison between the group with IAB versus without IAB was notable for a higher prevalence of stroke in those with IAB (24 subjects versus 16; p value = 0.013). The prevalence of atrial fibrillation was not statistically different between the two groups, but atrial flutter was noted to be more prevalent in those with IAB (16 subjects vs 9; p value = 0.018). Hypertension and male sex were also associated with IAB. Conclusions: Subjects with LHIS have a high prevalence of IAB, likely consequent to localized disruption in conduction through Bachmann’s bundle. We demonstrate a higher prevalence of atrial flutter and stroke in those with LHIS and IAB. These results highlight the importance of LHIS as a potential cause of IAB that can contribute to atrial structural remodeling and electromechanical dysfunction associated with atrial arrhythmia and stroke.

Visceral adiposity in patients with lipomatous hypertrophy of the interatrial septum.

Lipomatous hypertrophy of the interatrial septum (LHIS) is a benign cardiac mass determined by abnormal deposition of adipose tissue in the interatrial septum. The quantitative relationship between LHIS and visceral adiposity has not been explored to date.In this retrospective study, three groups of consecutive patients undergoing CT imaging were enrolled: L + with LHIS, L- without LHIS, and LO- without both LHIS and history of malignancies. Areas of total adipose tissue (TAT), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and LHIS areas were calculated on CT images. The relationship between LHIS and abdominal fat distribution was investigated with linear regression models. Bonferroni correction was applied to account for multiple testing. Statistical significance was set at 5%. In this study we enrolled a total of 175 subjects: 58 (33.14%) with LHIS (L +), 51(29.14%) without LHIS (L-) and 66 (37.71%) without both LHIS and medical history of malignancies (LO-). VAT (coeff: 105.82; 95% CI 59.37-152.27), SAT (coeff: 74.59; 95% CI 31.63-117.54), and TAT (coeff: 190.37; 95% CI 115.02-265.72), were significantly higher in L + patients. Moreover, VAT (coeff: 24.95; 95% CI 6.94-42.96) and TAT (coeff: 36.58; 95% CI 8.75-64.41) were statistically significant linear predictors for LHIS area. Here, we report a novel association between LHIS and visceral adiposity using a quantitative CT-based imaging approach. The results are of great importance also because they might drive early identification of subjects with LHIS at risk for visceral obesity, and trigger lifestyle interventions aimed at weight loss.

Interatrial Septum Hypertrophy: A Pitfall in Bicaval Cannulation

BACKGROUND: Lipomatous hypertrophy of the interatrial septum is a rare benign cardiac condition characterized by fatty tissue infiltration of the septum. CASE PRESENTATION: We presented some interesting images and some possible pitfalls during the cannulation in this circumstance. CONCLUSION: Surgical therapy appears to be reserved to patients with SVC obstruction or any rhythm disturbances.

Extinction of Lipomatous Hypertrophy of the Interatrial Septum FDG Uptake With Propranolol Premedication.

Lipomatous hypertrophy of the interatrial septum is a rare lesion of the heart. CT and cardiac MR are often sufficient to determine the benign lipomatous nature of the tumor and can avoid the need for histological confirmation. Lipomatous hypertrophy of the interatrial septum contains variable amounts of brown adipose tissue, resulting in different degrees of 18F-FDG uptake in PET. We report the case of a patient with an interatrial lesion suspected of malignancy, discovered on CT and failing cardiac MR, with initial 18F-FDG uptake. Final characterization was made thanks to 18F-FDG PET with β-blocker premedication, avoiding an invasive procedure.

Tłuszczakowaty przerost przegrody międzyprzedsionkowej — rozpoznanie, o którym nie powinno się zapominać

Lipomatous hypertrophy of the interatrial septum (LHIS) is a benign condition histologically described as an excessive fat deposition in the interatrial region of the heart. Since the clinical features often remain asymptomatic, it is usually an incidental finding on cardiac imaging. This report presents a case of a 63-year-old woman with a firstly diagnosed atrial fibrillation and leg oedema. Those findings were then followed by echocardiography, revealing a cardiac mass within the interatrial septum. Typical characteristics of the mass, confirmed further on both computed tomography and cardiac magnetic resonance imaging, lead to the final diagnosis of LHIS and spared the patient a surgical resection. It should be noted that cardiac lesions can be diagnosed as benign using non-invasive imaging. Such cases very seldom need treatment, therefore a correct distinction of the mass with use of multimodality imaging techniques can help in making proper diagnosis and qualification to surgical interventions.

358 A POSSIBLE RARE CASE OF VENTRICULAR LIPOMATOSIS: A STIMULUS FOR A PANORAMA OF FATTY CARDIAC LESIONS

Abstract We exhibit the case of a 75 years-old man who undertook cardio-oncological assessment for Non-Hodgkin Lymphoma: baseline echo revealed typical features of lipomatous hypertrophy of the interatrial septum (LHIS) and an apical hypoechoic left ventricle (LV) lesion. Five years before, the patient performed MRI (Magnetic Resonance Imaging), which confirmed LHIS, but superabundant epicardial fat extended to the right ventricle and the apical junction between the two ventricles, both characterized by normal ejection fraction, and surrounded the origin of the pulmonary trunk. LV lateral and inferior walls presented lipomatous metaplasia foci and no history or ECG sign of previous myocardial injury could be pointed out. A slight band of late gadolinium enhancement at the basal infero-lateral wall of LV was highlighted. The patient referred episodes of fainting: the Holter-ECG showed pronounced bradycardia which couldn't be explained by other secondary causes. So a bicameral pace-maker was implanted. During our ambulatory evaluation, we decided to repeat MRI, which showed no difference in comparison with the previous one, so excluding malignant degeneration of the fatty mass surrounding the heart. Despite older age and the lack of sudden cardiac death family history we searched for pathognomonic arrhythmogenic cardiomyopathy (ACM) mutations. In consideration of the new evidence of the metabolic risk associated with abundant epicardial fat (EF) we asked for updated laboratory dosage of plasma glucose, LDL cholesterol and triglycerides and we recommended stricter control of blood pressure. From 4% to 52% of cardiac mass is made up of fat but only EF interacts with myocardium and coronary arteries. Anomalous growth of fat in the heart can present itself as LHIS, excessive lipomatous infiltration or cardiac lipomas (real capsulated tumors) but also ACM is histologically characterized by fibrofatty replacement of cardiomyocites. Overabundant and inflammed EF is now considered a surrogate of metabolic risk and is associated with multivessel coronary disease, the finding of chronic total occlusions (CTO) and microvascular angina. Identifying fatty heart lesions and defining their clinical and prognostic role remains an intriguing challenge. We suggest a general binary way to follow: the “mechanic one” for lipomas or lipomatous infiltration, that is paying attention to compression phenomena or the generation of arrhythmias, and the “metabolic one”, in other words optimizing cardiovascular prevention when EF is too much. A careful research of imaging features of ACM can't be omitted.

Клинико-морфологические особенности липоматозной гипертрофии межпредсердной перегородки у пациентов с заболеваниями сердечно-сосудистой системы

INTRODUCTION: Epicardial adipose tissue is usually located on the free wall of the right ventricle, the left ventricular apex, and the atria, but the valvular apparatus of the heart, the interventricular and interatrial septum can be subjected to lipotoxic damage. The accumulation of adipose tissue on the interatrial septum is of particular scientific interest and is described in the literature as lipomatous hypertrophy. AIM: To study the clinical and morphological features of lipomatous hypertrophy of interatrial septum in patients with diseases of the cardiovascular system. MATERIALS AND METHODS: Morphological examination of the hearts of 60 patients (30 men, 30 women), average age 74.6 ± 9.5 years was conducted. Morphometric parameters of the heart muscle and the aorta were evaluated. The studied heart material was stained with hematoxylin-eosin and according to Mallory and was processed by standard histological methods. RESULTS: The causes of death of patients were myocardial infarction, cerebral infarction, postinfarction cardiosclerosis and type 2 diabetes. The analysis of thickness of the interatrial septum in patients of different groups revealed lipomatosis of the interatrial septum in 83% of patients with postinfarction cardiosclerosis, in 80% of patients with myocardial infarction, in 70% with type 2 diabetes, in 66.7% with cerebral infarction. The thickness of the interatrial septum with lipomatous hypertrophy was 1.2 ± 0.12 cm in patients with myocardial infarction, 1.2 ± 0.11 cm in cerebral infarction, 1.2 ± 0.2 cm in postinfarction cardiosclerosis, 1.2 ± 0.15 cm in type 2 diabetes. There were no reliable differences in the thickness of the interatrial septum between the study groups. The correlation was established between the thickness of the interatrial septum with lipomatous alterations and hypertrophy of the anterior wall of the left ventricle (r = 0.7; р < 0.0001), fibrosis of the anterior wall of the left ventricle (r = 0.6; p = 0.03), thickness of epicardial fat (r = 0.5; p = 0.0002), as well as the interrelation with the thickness of the interventricular septum (r = 0.7; p < 0.05). The existence of epicardial fat in individuals with lipomatosis of the interatrial septum positively correlated with the thickness of the interventricular septum (r = 0.5; p = 0.01) and the thickness of the posterior wall of the left ventricle (r = 0.6; p = 0.001). The correlation relationship was also established between the thickness of the interatrial septum with lipomatous alterations and laboratory markers of cardiovascular risk: the level of total cholesterol (r = 0.8; p = 0.01), triglycerides (r = 0.6; p = 0.001), low-density lipoproteins (r = 0.7; p = 0.001). CONCLUSION: Taking into account the interrelations of lipomatous hypertrophy of the interatrial septum identified in the morphological and histological examination, as well as echocardiography data and some biochemical markers, this parameter can be recommended for use in assessment of cardiovascular risk in echocardiography.

P138 CARDIAC LIPOMA IN PATIENT WITH SYSTEMIC LIPOMATOSIS

Abstract Introduction Primary adipose cardiac tumors are divided into two different entities: lipomatous hypertrophy of the interatrial septum (LHIS) and lipomas. Lipomas are usually benign masses of unknown pathogenesis. Currently few cases are reported in literature, with no differences in gender distribution. Clinical Case A 63–year–old patient presented to our emergency room complaining chest pain and dyspnea on exercise. Her medical history shows severe obesity, hypertention, past surgical removal of several systemic lipomas (uterus lipoma, right ovary lipoma, right thigh and leg lipoma, right forearm and wrist lipoma). A coronary angiography was performed showing the lack of angiographically significant lesions. On suspicion of microvascular angina, she began therapy with Ranolazine and Beta–blockers. Echocardiographic examination showed a lipomatous interatrial septum in the postero–superior tract with a maximum of 22.5mm thickness (image 1). At 12 months, chest CT and MRI scan showed a hyperintense mass on interatrial septum measuring 32x34mm. The formation, mainly protruding in the right atrium, does not obstruct the outlet of the hollow veins, nor the outlet of the pulmonary veins. No hemodynamic compromise and compression were detected. Last follow–up visit our patient presented dyspnea and chest pain, the echocardiogram showed a slight increase of the mass size (see image), with unchanged thicknesses and biventricular pump function. Conclusions In literature there is no evidence of malignant transformation of cardiac lipomas, however well–differentiated cell tumors can coexist with liposarcomas. There are no guidelines for the treatment of cardiac lipomas, radical resection is practiced in the majority of symptomatic patients and should be considered in all patients with cardiac lipoma. Asymptomatic lipomas can excessively grow up and infiltrate into the myocardium, resulting in negative outcomes to a possible subsequent resection. According to the worsening of the clinical course, the patient under consideration was referred for lipoma resection surgery.

18F-FDG PET/CT helps rule out malignancy in lipomatous hypertrophy of the interatrial septum with atypical MRI manifestations, to avoid unnecessary surgical treatment.

Lipomatous hypertrophy of the interatrial septum (LHIS) is a rare benign heart disease characterized by excessive deposition of adipose tissue in the atrial septum with sparing fossa ovalis, which demonstrates a characteristic hourglass/dumbbell configuration. We reported a case of LHIS with inhomogenous characteristic on CMR and persistently no FDG uptake on 18F-FDG PET-CT, which is contrary to a few previous cases. This single case report suggests that in case LHIS present in-homogenous characteristic on CMR, metabolic PET imaging could be used as a complementary imaging model to decrease the concern of lipomatous neoplasms, thereby avoid unnecessary surgical therapy.

An unusual co-occurrence of lown-ganong-levine syndrome with neonatal focal lipomatous hypertrophy of interatrial septum with patent foramen ovale

We report an extremely rare co-occurrence of focal lipomatous hypertrophy of the interatrial septum (LHIS) with patent foramen ovale (PFO) in a neonate and electrocardiogram evidence of Lown-Ganong-Levine syndrome (LGL). Although atrial arrythmias in the form of supraventricular tachycardia like atrial premature contractions, atrial fibrillation, and atrioventricular block have been described in lipomatous hypertrophy interatrial septum, co-occurrence of LGL syndrome with LHIS has not been described in literature so far. Baby presented in the cardiology outpatient department for presurgical cardiological evaluation of congenital hydrocephalus. Typically, LHIS spares fossa ovalis and affects both side of the interatrial septum making interatrial septum dumbbell shaped. There is even no literature description of focal hypertrophy of interatrial septum in early infancy and child hood including neonatal period. Our case is a unique illustration of a rare co-occurrence of LGL syndrome in focal lipomatous hypertrophy of interatrial septum in a neonate with PFO.

Lipomatous Hypertrophy of Interatrial Septum Presenting with Two Distinct Atrial Arrhythmias

Lipomatous Hypertrophy of the Interatrial Septum (LHIS) is usually a benign condition, but it has been known to produce a variety of symptoms and arrhythmias. Management is guided by symptoms and can range from watchful waiting to surgical resection. Here we describe a unique case of a patient with LHIS associated with two distinct atrial arrhythmias. Due to persistent symptoms an EP study with ablation was pursued which resulted in abatement of symptoms. This case illustrates that an EP study and ablation is a viable option that could be considered in patients with continued symptoms in conjunction with medical or surgical options and ultimately lead to prompt diagnosis and appropriate treatment.

"WHAT AN IMPOSTER!" LIPOMATOUS HYPERTROPHY OF THE ATRIAL SEPTUM: A DIAGNOSTIC CHALLENGE IN CARDIAC IMAGING

TOPIC: Cardiovascular Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: Lipomatous hypertrophy of the atrial septum (LHAS) is a rare, non-neoplastic fatty infiltration of the inter-atrial septum that spares the fossa ovalis. It is best differentiated from other cardiac tumors with transesophageal echocardiogram (TEE) and cardiac computed tomographic (CT) or magnetic resonance (MR) imaging. CASE PRESENTATION: A 52-year-old woman with diabetes, hypertension and a chronic tobacco smoker, presented with complaints of shortness of breath. An electrocardiogram showed non-specific ST-T wave changes. A TTE revealed an ejection fraction of 60% and a well-encapsulated mass in the right atrium; the differential diagnosis of the mass included entities such as atrial myxoma. Further evaluation with a TEE demonstrated a large, sessile, immobile mass in the right atrium with a characteristic dumbbell shaped thickening of the atrial septum, thus raising the possibility of lipomatous hypertrophy of the atrial septum (LHAS). Cardiac MRI confirmed the distinctive hour-glass shaped mass in the intra-atrial septum, with characteristic sparing of the fossa ovalis. There was no contrast enhancement and lacked signal on fat suppression sequences confirming benign LHAS. DISCUSSION: LHAS is a rare, non-neoplastic abnormality of the heart. Unlike other cardiac tumors such as myxomas and papillary fibroelastomas which require surgical intervention, LHAS is a benign finding. It is thought to be an infiltration of brown adipose tissue into the myocytes of the interatrial septum. Most cases remain clinically silent and are detected incidentally during echocardiography, surgery or autopsy. Echocardiography, where a TEE is more sensitive than a TTE, and cardiac MRIs demonstrate a characteristic dumbbell or hour-glass shaped appearance. Tailored MRI sequences with lack of gadolinium enhancement and fat suppression imaging, differentiate it from other intracardiac neoplasms, including myxomas. Moreover, positron emission tomography (PET) scans will show high fluorodeoxyglucose (FDG) uptake by the brown adipose tissue that may further aid in diagnosis. Rare complications of LHAS include SVC syndrome, sick-sinus syndrome and other life-threatening arrhythmias that may warrant surgical intervention. CONCLUSIONS: LHAS is an uncommon cardiac anomaly. The utility of TEE and cardiac MRI, in this case, aids in defining the benign nature of LHAS. REFERENCE #1: Nadra I. Lipomatous hypertrophy of the ineratrial septum; a commonly misdiagnosed mass often leading to unnecessary cardiac surgery. Heart. 2004;90(12):66. REFERENCE #2: Heyer C, Kagel T, Lemburg S, Bauer T, Nicolas V. Lipomatous hypertrophy of the interatrial septum. Chest. 2003;124(6):2068–2073. doi: 10.1378/chest.124.6.2068. DISCLOSURES: No relevant relationships by Adhiraj Bhattacharya, source=Web Response No relevant relationships by Rizwan Khan, source=Web Response No relevant relationships by Michael Maysky, source=Web Response

Changing appearance of lipomatous hypertrophy of the interatrial septum on positron emission tomography scan.

Changing appearance of lipomatous hypertrophy of the interatrial septum on positron emission tomography scan.

Telocytes/CD34+ Stromal Cells in Pathologically Affected White Adipose Tissue

We studied telocytes/CD34+ stromal cells (TCs/CD34+SCs) in pathologically affected white adipose tissue after briefly examining them in normal fat. To this aim, we reviewed pathological processes, including original contributions, in which TCs/CD34+SCs are conserved, increased, and lost, or acquire a specific arrangement. The pathologic processes in which TCs/CD34+SCs are studied in adipose tissue include inflammation and repair through granulation tissue, iatrogenic insulin-amyloid type amyloidosis, non-adipose tissue components (nerve fascicles and fibres in neuromas and hyperplastic neurogenic processes) and tumours (signet ring carcinoma with Krukenberg tumour and colon carcinoma) growing in adipose tissue, adipose tissue tumours (spindle cell lipoma, dendritic fibromyxolipoma, pleomorphic lipoma, infiltrating angiolipoma of skeletal muscle and elastofibrolipoma), lipomatous hypertrophy of the interatrial septum, nevus lipomatosus cutaneous superficialis of Hoffman–Zurhelle and irradiated adipose tissue of the perirectal and thymic regions. Two highly interesting issues emerged: (1) whether the loss of CD34 expression in TCs/CD34+SCs is by changes in marker expression or the disappearance of these cells (the findings suggest the first possibility) and (2) whether in some invasive and metastatic malignant tumours, TCs/CD34+SCs that completely surround neoplastic cells act as nurse and/or isolating cells. Further studies are required on adipose tissue TCs/CD34+SCs, mainly in lipomatosis and obesity.

Hipertrofia lipomatosa del septum interatrial: reporte de un caso

La hipertrofia lipomatosa del septum interauricular (HLSI) es una entidad cardiaca rara y benigna, que se caracteriza por la acumulación de tejido adiposo dentro de algunos segmentos del septum interatrial. Generalmente, los pacientes son asintomáticos y estas lesiones se descubren de manera incidental mediante estudios de imagen realizados por otras razones, o en el contexto de una autopsia. Se han descrito casos de muerte súbita por alteración del ritmo cardiaco en estos pacientes. El diagnóstico diferencial de la HLSI incluye principalmente tumores cardiacos. Se expone el caso de un paciente de 61 años que, después de un estudio de resonancia magnética cardiaca, realizado por una alteración del ritmo cardiaco, presenta una masa en el septum auricular. El paciente es llevado a cirugía y el estudio histopatológico de la lesión confirma el diagnóstico. Se realiza una revisión de las características clínicas y patológicas de la HLSI.

108 Uncommon cardiac fatty distribution: a case report

Abstract Background Fatty masses of the heart are relatively uncommon. This report is about a rare case of extensive fat infiltration along the apical interventricular septum that causes separation of the right ventricular apex from left ventricular apex, simulating a bifid cardiac apex. Case summary The patient was a 58-year-old female who was admitted to the hospital because of palpitations and chest pain. A trasnsthoracic echocardiogram was performed and it showed a thickenned anterior pericardium so a cardiovascular magnetic resonance (CMR) was performed. CMR revealed a large amount of epicardial and pericardial fat without adipose tissue inside the right ventricle wall. In the cardiac apex this fat seemed a lipoma however CMR demonstrated the fat was not capsulated and besides, it extended, as if it were an infiltrative disorder, in the cardiac apex between both ventricles. Patient was discharged with an implantable loop recorder (ILR) in order to ruled out ventricular arrhythmia. During a two year follow-up, ILR has shown several symptomatic supraventricular paroxysmal tachycardia episodes and no other arrhythmic events have been reported. Also, the CMR has been repeated and it has shown similar results. Discussion Fatty masses of the heart are relatively uncommon. Among those masses are included cardiac lipomas, lipomatous infiltration of the right ventricle, arrhythmogenic right ventricular dysplasia (ARVD) and lipomatous hypertrophy of the interatrial septum. The findings in the CMR of our patient do not fulfill the criteria of the aforementioned disorders. Our patient shows a pattern of unusual fatty infiltration pattern of unclear etiology. The prognostic value of this type of heart disease is unknown. In our patient, although the follow-up has not been very long, it does not seem to have had any relevant consequences, so far. Conclusion This is a rare case of a patient with a large amount of epicardial and pericardial fat that seems to infiltrate between both ventricular apex, as a bifid cardiac apex. It is apparently asymptomatic. Abstract 108 Figure. CMR-Cardiac-fatty_EECHO-2019

P406Recurrent atrial fibrillation associated with lipomatous hypertrophy of the interatrial septum (LHIS): a case report

P406Recurrent atrial fibrillation associated with lipomatous hypertrophy of the interatrial septum (LHIS): a case report

Adipose tumors of the heart.

Primary cardiac adipose tumors are rare. There are two distinct pathologically defined entities that represent this tumor type: lipoma and lipomatous hypertrophy of the interatrial septum (LHIS). We present a single-center experience with these tumors and demonstrate that the location may not correspond to the pathologic diagnosis. A retrospective review of a prospectively collected cardiac surgery database from January 1990 to July 2016 identified 254 cases of surgically treated primary cardiac tumors at our Institution. Of these, 06/254 (2%) were primary adipose tumors. In 3/6 (50%) cases, patients were asymptomatic or had symptoms referable to other known intracardiac lesions. Five patients (83%) had preserved ventricular function. In 4/6 cases (67%), the tumor was identified preoperatively. All patients presented in New York Heart Association functional class ≤2. Pathologic diagnosis of LHIS was made in 5/6 cases (83%), with 2/5 LHIS (40%) located in the interatrial septum. A bovine pericardial patch was utilized for reconstruction following tumor resection in 3/6 cases (50%). Mean cardiopulmonary bypass time was 88 ± 43 min. All the patients tolerated the procedure well without any postoperative complications. Primary cardiac adipose tumors are responsible for a small portion of all primary heart tumors. Surgical resection provided excellent outcomes, and did not affect cardiac performance, in spite of the need for extensive resections. LHIS was identified in locations other than the interatrial septum and was usually symptomatic.

Incidental finding of lipomatous hypertrophy of the interatrial septum during 18F-fluorodeoxyglucose positron emission Tomography–Computed tomography for cervical cancer

Lipomatous hypertrophy of the interatrial septum is a benign but less recognized pathology of the heart caused by benign fatty infiltration of the interatrial septum which most often spares the fossa ovalis. We share images of the incidentally detected fluorodeoxyglucose (FDG) uptake in the interatrial septum during the restaging of 18F-FDG positron emission tomography/computed tomography scan of cervical cancer.