Cardiac lipoma

Cardiac lipomas are uncommon benign primary cardiac neoplasms and occur across a wide although they are considered the commonest non-myxomatous benign primary cardiac tumour ⁸.

Epidemiology

They have no defined age rangeor sex distribution.

Clinical presentation

They are soft and may grow to a large size without causing symptoms and are usually incidentally discovered. In the pericardial space, they may compress the ventricles or cause shortness of breath by displacing the lungs without affecting left ventricular function.

Pathology

Associations

Cardiac lipomas have been associated with a variety of arrhythmias.

Location

They can arise in variety of locations and some may arise in relation to papillary muscles ⁸.

Radiographic features

Echocardiography

In general, cardiac lipomas usually appear as hyperechoic masses on echocardiography due to their fat content. However, the appearance of lipomas on echocardiography may also vary depending on their location. Lipomas in the pericardial space may appear as hypoechoic lesions, whereas those located within the cardiac chambers are homogeneous and hyperechoic.

CT

On CT, cardiac lipomas appear as homogeneous, low-attenuation masses either in a cardiac chamber or in the pericardial.

MRI

May be superior to CT in identifying relationship of the lipoma to coronary arteries ⁴.

On MR imaging, lipomas have homogeneous increased signal intensity on T1-weighted images that decreases with fat-saturated sequences. Cardiac lipomas do not enhance with the administration of contrast material.

Treatment and prognosis

In most cases, cardiac lipomas require no treatment or surgical intervention unless they cause cause arrhythmias, embolise, compress the coronary arteries, or obstruct flow within the heart. Cardiac lipomas are usually easily resected.

See also

• lipomatous hypertrophy of the interatrial septum