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Ying Cai, Xin Dai, Xiaohu Li, Bo Zhang, A rare case of cardiac lipoma: necrotic and calcified tumour in the right atrium, European Heart Journal - Cardiovascular Imaging, Volume 26, Issue 4, April 2025, Page 769, https://doi.org/10.1093/ehjci/jeaf012
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A 56-year-old female patient presented with a 1-week history of palpitations and chest tightness. Cardiac ultrasound identified bilateral atrial enlargement, a mass within the right atrium, and mild pericardial effusion (Panel A). The mass measured ∼30 mm in length and 19 mm in width. Cardiac computed tomography imaging revealed a mixed-density circular shadow with calcifications in the right atrium, with no significant enhancement observed on contrast-enhanced examination (Panels B–F). During surgery, a mass measuring ∼4 cm in length and 2 cm in width was successfully resected from the right atrium, ensuring complete removal. Postoperative histopathological analysis confirmed the diagnosis of a lipoma with fat necrosis and calcium deposition (Panels G and H).
Cardiac lipoma is a rare, benign tumour that is typically asymptomatic, often remaining undetected or identified incidentally. However, cases of right atrial lipoma with associated fat necrosis and calcification are exceedingly rare, posing challenges due to the absence of characteristic imaging findings. As a result, it is often misdiagnosed as a cardiac myxoma or a thrombus with calcification. In cases with atypical presentations, preoperative biopsy and confirmation are essential for accurate prognostic evaluation and guiding treatment decisions.
