1
|
Elenizi K, Matta A, Alharthi R, Campelo-Parada F, Lhermusier T, Bouisset F, Elbaz M, Carrié D, Roncalli J. Incidental discovery of right ventricular lipoma in a young female associated with ventricular hyperexcitability: An imaging multimodality approach. World J Cardiol 2020; 12:220-227. [PMID: 32547716 PMCID: PMC7284002 DOI: 10.4330/wjc.v12.i5.220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/08/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cardiac lipomas are rare benign tumors commonly found in the right atrium or left ventricle. Patients are usually asymptomatic, and clinical presentation depends on location and adjacent structures impairment. Right ventricle lipomas are scarce in the literature. Moreover, the previous published cases were reported in over 18-year-old patients.
CASE SUMMARY We report a giant right ventricle lipoma discovered incidentally in a 17-year-old female while performing preoperative work-up. The diagnosis was confirmed by histopathological examination, and a conservative approach was performed.
CONCLUSION Multimodal cardiac imaging and histopathological examination are required for a definitive diagnosis. The therapeutic approach depends on clinical presentation.
Collapse
Affiliation(s)
- Khaled Elenizi
- Department of Internal Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia
- Cardiovascular Department, Institute CARDIOMET, Rangueil University Hospital, Toulouse 31400, France
| | - Anthony Matta
- Cardiovascular Department, Institute CARDIOMET, Rangueil University Hospital, Toulouse 31400, France
- Faculty of Medicine, Holy Spirit University of Kaslik, Kaslik 1103, Lebanon
| | - Rasha Alharthi
- Cardiovascular Department, Institute CARDIOMET, Rangueil University Hospital, Toulouse 31400, France
| | - Francisco Campelo-Parada
- Cardiovascular Department, Institute CARDIOMET, Rangueil University Hospital, Toulouse 31400, France
| | - Thibault Lhermusier
- Cardiovascular Department, Institute CARDIOMET, Rangueil University Hospital, Toulouse 31400, France
| | - Frederic Bouisset
- Cardiovascular Department, Institute CARDIOMET, Rangueil University Hospital, Toulouse 31400, France
| | - Meyer Elbaz
- Cardiovascular Department, Institute CARDIOMET, Rangueil University Hospital, Toulouse 31400, France
| | - Didier Carrié
- Cardiovascular Department, Institute CARDIOMET, Rangueil University Hospital, Toulouse 31400, France
| | - Jerome Roncalli
- Cardiovascular Department, Institute CARDIOMET, Rangueil University Hospital, Toulouse 31400, France
| |
Collapse
|
2
|
Lipomatous Hypertrophy of the Atrial Septum in a Patient Undergoing Coronary Artery Bypass Surgery. Case Rep Pathol 2017; 2016:2080875. [PMID: 28078155 PMCID: PMC5204074 DOI: 10.1155/2016/2080875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 11/14/2016] [Indexed: 11/17/2022] Open
Abstract
Background. Lipomatous hypertrophy of the atrial septum (LHAS) is a rare entity characterized by mass-forming deposition of fatty tissue within the atrial septum. To date, <300 cases have been reported; many of them were autopsy findings. The clinical presentation of LHAS varies from incidental asymptomatic mass (most frequent form) to severe life-threatening cardiovascular complications necessitating emergency cardiac surgery. Case Presentation. Here, we present the successful surgical resection of such a massive LHAS which was found incidentally on preoperative investigation of a 71-year-old patient with progressive coronary heart disease. Histology confirmed the diagnosis of lipomatous hypertrophy of the atrial septum. Conclusions. The described case report illustrates an unusual example of LHAS in a patient undergoing a planned coronary artery bypass surgery. In this case, surgical intervention was justified to avoid later outflow obstructions.
Collapse
|
3
|
Baikoussis NG, Argiriou O, Kratimenos T, Dedeilias P, Argiriou M. Lipomatous hypertrophy of the interatrial septum and fibrosing mediastinal lymphadenopathy causing superior vena cava obstruction. Ann Card Anaesth 2016; 18:609-11. [PMID: 26440257 PMCID: PMC4881660 DOI: 10.4103/0971-9784.166487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Lipomatous hypertrophy of the interatrial septum (LHIS) is an uncommon cause of superior vena cava syndrome (SVCS). Fibrosing mediastinal lymphadenopathy is another cause of SVCS. We present a 65-year-old female patient with a history of tuberculosis (TB) and the coexistence of LHIS and fibrosing mediastinitis due to TB of the lung. Fibrosing or sclerosing mediastinitis is a rare entity with few cases published in the western literature. She presented with mild symptomatology of SVCS and she underwent on transthoracic and transesophageal echocardiography, computed tomography scan, magnetic resonance imaging, and venography. Due to the development of an abundant collateral venous system seen on venography and her negation for any treatment, she did not undergo yet on any intervention. To our knowledge, this is the first case reported in the international bibliography in which LHIS and sclerosing lymphadenopathy are simultaneously diagnosed in the same patient.
Collapse
Affiliation(s)
- Nikolaos G Baikoussis
- Department of Cardiovascular and Thoracic Surgery, Evangelismos General Hospital of Athens, Athens, Greece
| | | | | | | | | |
Collapse
|
4
|
A Benign Cardiac Growth but Not So Indolent. Case Rep Cardiol 2016; 2016:8794202. [PMID: 27293911 PMCID: PMC4884802 DOI: 10.1155/2016/8794202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/28/2016] [Indexed: 11/17/2022] Open
Abstract
Cardiac lipomatous hypertrophy is a rare benign condition that usually involves the interatrial septum. Due to its benign nature it rarely requires intervention. Its presence outside the interatrial septum is reported infrequently. We present a case of lipomatous hypertrophy in the intraventricular septum that was complicated by a severe, symptomatic, and disabling dynamic left ventricular outflow tract obstruction. The symptoms significantly improved following the excision of the mass. In our case transthoracic echocardiogram was used to visualize the mass and measure the severity of the obstruction; Cardiac Magnetic Resonance Imaging was used to characterize the mass and histopathology confirmed the diagnosis.
Collapse
|
5
|
Fang L, He L, Chen Y, Xie M, Wang J. Infiltrating Lipoma of the Right Ventricle Involving the Interventricular Septum and Tricuspid Valve: Report of a Rare Case and Literature Review. Medicine (Baltimore) 2016; 95:e2561. [PMID: 26817909 PMCID: PMC4998283 DOI: 10.1097/md.0000000000002561] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 12/21/2015] [Accepted: 12/28/2015] [Indexed: 12/12/2022] Open
Abstract
Cardiac lipoma, which are primary cardiac tumors, are rare entities often detected incidentally during imaging. There have been very few reports on the right ventricle (RV) lipoma. Here, we present a case of RV infiltrating lipoma involving the interventricular septum (IVS) and the tricuspid valve. Clinical symptoms, diagnostic procedures, multimodality imaging characteristics, and treatment are discussed, and the complete clinical data of this case and relevant details of retrospective literature are reviewed. The study described the case of a 48-year-old woman who suffered from occasional palpitation after exertion for 10 years. Imaging examinations, including echocardiography and cardiovascular magnetic resonance imaging (MRI), revealed a large mass adherent to the IVS and the right ventricular wall that was consistent with lipoma. The patient underwent surgical repair of the tricuspid valve and excision of the partial mass. The gross specimen revealed piles of 5 × 4 × 3 cm fragments with yellowish appearance and pathological results showed infiltrating lipoma.Lipoma is often asymptomatic and diagnosed incidentally. Surgical excision is the main therapeutic intervention, which is always performed in cases of symptomatic lipoma or when malignancy is suspected. Multimodality imaging would be great help in the diagnosis of cardiac lipoma. Echocardiography is a convenient method for follow-up.
Collapse
Affiliation(s)
- Lingyun Fang
- From the Department of Ultrasound (LF, LH, MX, JW); and Department of Radiology (YC), Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | | | | | | |
Collapse
|
6
|
Ak K, Isbir S, Kepez A, Turkoz K, Elci E, Arsan S. Large lipomatous hypertrophy of the interventricular septum. Tex Heart Inst J 2014; 41:231-3. [PMID: 24808791 DOI: 10.14503/thij-13-3336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We present the case of a 58-year-old woman who had large lipomatous hypertrophy of the interventricular septum, a condition that is reported very infrequently. Preoperative cardiac magnetic resonance images revealed an inhomogeneous, infiltrating mass that was suppressed in fat-suppression mode. The extensive mass was causing right ventricular dysfunction, so we excised it through a right ventricular approach. The findings on histologic analysis of the mass were consistent with lipomatous hypertrophy. The patient died of septic shock on the 28th postoperative day. In addition to the patient's case, we discuss the characteristics and diagnosis of this rare entity.
Collapse
Affiliation(s)
- Koray Ak
- Departments of Cardiovascular Surgery (Drs. Ak, Arsan, Elci, and Isbir), Cardiology (Dr. Kepez), and Pathology (Dr. Turkoz), Marmara University School of Medicine, 34899 Istanbul, Turkey
| | - Selim Isbir
- Departments of Cardiovascular Surgery (Drs. Ak, Arsan, Elci, and Isbir), Cardiology (Dr. Kepez), and Pathology (Dr. Turkoz), Marmara University School of Medicine, 34899 Istanbul, Turkey
| | - Alper Kepez
- Departments of Cardiovascular Surgery (Drs. Ak, Arsan, Elci, and Isbir), Cardiology (Dr. Kepez), and Pathology (Dr. Turkoz), Marmara University School of Medicine, 34899 Istanbul, Turkey
| | - Kemal Turkoz
- Departments of Cardiovascular Surgery (Drs. Ak, Arsan, Elci, and Isbir), Cardiology (Dr. Kepez), and Pathology (Dr. Turkoz), Marmara University School of Medicine, 34899 Istanbul, Turkey
| | - Emre Elci
- Departments of Cardiovascular Surgery (Drs. Ak, Arsan, Elci, and Isbir), Cardiology (Dr. Kepez), and Pathology (Dr. Turkoz), Marmara University School of Medicine, 34899 Istanbul, Turkey
| | - Sinan Arsan
- Departments of Cardiovascular Surgery (Drs. Ak, Arsan, Elci, and Isbir), Cardiology (Dr. Kepez), and Pathology (Dr. Turkoz), Marmara University School of Medicine, 34899 Istanbul, Turkey
| |
Collapse
|
7
|
Nezafati MH, Javan H, Maleki MH, Hamedanchi A. Lipomatosis of interventricular septum and both ventricles: an extremely rare pattern. Interact Cardiovasc Thorac Surg 2011; 12:511-2. [DOI: 10.1510/icvts.2010.258020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|