Giant Lipoma Originating from the Right Ventricular Infundibulum - A Case Report Lucian Florin Dorobantu 1 , Ovidiu Stiru 1 , Catalina Andreea Parasca 1* , Vlad Anton Iliescu 1 and Serban Ion Bubenek-Turconi 2 1 Department of Cardiovascular Surgery, "CC Iliescu" Emergency Institute for Cardiovascular Diseases, Bucharest, Romania 2 Department of Intensive Care, "CC Iliescu" Emergency Institute for Cardiovascular Diseases, Bucharest, Romania * Corresponding author: Catalina Andreea Parasca, Department of Cardiovascular Surgery, "CC Iliescu" Emergency Institute for Cardiovascular Diseases, Bucharest, Romania, Tel: +40-773-842-692; Fax: + 40-21-317-52-21; E-mail: catalina.parasca@gmail.com Received date: June 7, 2015; Accepted date: June 25, 2015, Published date: June 30, 2015 Copyright: ©2015 Dorobantu FL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Known as a rare benign cardiac tumor, epicardial lipoma is often an asymptomatic condition discovered due to increasing use of diagnostic imaging techniques. We report a case of a 54-year old patient referred to our institution with mild dyspnea, chough and an enlarged cardiac siluette on a routine chest X-ray. A large intrapericardial mass suggestive for lipoma encompassing the left and right ventricles was detected by echocardiographic examination and computer tomography scan. Resection of a 650 g mass with right ventricular infundibulum origin was performed via sternotomy, with histopathological confirmation of epicardial lipoma. Keywords: Benign tumour; Epicardial lipoma; Surgery Introduction Cardiac lipoma accounts for 10% of the benign tumors of the heart, generally consisting of encapsulated fatty tissue with variable origin and location [1]. Although they can present with symptoms such as fatigue, dyspnea, palpitations, chest pain or discomfort, many of the diagnosed cardiac lipomas are asymptomatic and represent an incidental finding on imaging studies [2]. In rare cases, when the tumoral mass becomes very large in size, electrocardiographic abnormalities, ventricular tachycardia and even sudden death have been described, together with pronounced symptoms of left or right outflow tract obstruction [3]. Case report A 54-year-old man with New York Heart Association (NYHA) class III dyspnea and non-productive cough presented in a medium-care hospital. Beside hypertension and obesity class 1, there were no remarkable findings on physical examination. All laboratory testing, including erythrocyte sedimentation rate, serum C-reactive protein concentration and white blood cell count were within normal limits, yet the patient had a history of previously diagnosed and treated dyslipidemia. The electrocardiogram showed normal sinus rhythm with no additional pathological findings. The chest X-ray revealed an enlargement of the cardiac silhouette and bilateral hilar abnormalities, without evidence of pleural effusion (Figure 1a). As further investigations were required, the patient was referred to our clinic. While standard initial testing was unremarkable, on echocardiographic examination a large intrapericardic mass was described, approximately 11 cm length, 6 cm width and 2 cm thickness, encapsulated, with moderate echogenicity and surrounding the right and left ventricle. Although suggestive for lipomatous tumor, a CT scan was performed to exclude other possible conditions with pericardial involvement. Diagnostic imaging confirmed initial suspicion of intrapericardic lipomatous tumor (Figures 1b and 1c). As the patient was symptomatic, there was a clear indication for surgical resection of the intrapericadic tumor. Figure 1: Preoperative imaging studies: (A) Chest X-ray showing enlargement of the cardiac silhouette; (B) Echocardiography examination showing a echogenic large intrapericardic mass; (C, D) CT-scan showing intrapericardic mass mimicking pericardial effusion. Dorobantu et al., J Clin Exp Cardiolog 2015, 6:6 DOI: 10.4172/2155-9880.1000379 Case Report Open Access J Clin Exp Cardiolog ISSN:2155-9880 JCEC, an open access journal Volume 6 • Issue 6 • 1000379 Journal of Clinical & Experimental Cardiology J o u r n a l o f C l i n ic a l & E x p e r i m e n t a l C a r d i o l o g y ISSN: 2155-9880