Why the study?
Intravascular lipomas are rare, particularly in major vessels, with only eight prior reports of intravascular lipoma located in the superior vena cava.
Surgical excision of a rare giant intravascular lipoma in the superior vena cava can be safely performed without extensive manipulation, yielding good long-term outcomes.
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Rare SVC lipoma may underlie refractory SVT; leaves open need for targeted imaging in select arrhythmia cases.
Background: Intravascular lipomas were a rare occurrence, especially in major vessels. This tumor is composed of adipocytes in a fibrous capsule that had a slow growth rate and usually shows no symptoms. There were only eight reports in the literature regarding intravascular lipoma located in the superior vena cava. Case presentation: A 54-year-old man had episodes of supraventricular tachycardia and atrial flutter for over a year. Radiological findings preoperative showed a giant mass that arose from superior vena cava to right atrium and biopsy catheter showed that there were no signs of malignancy. The patient then underwent surgery through a median sternotomy and the mass was extirpated on the highest part of the stalk that could be reached. The patient was stable and remains to show no symptoms or evidence of residual mass or stalk in 2 years follow-up. Conclusion: The surgical approach in excising lipoma in SVC should be considered wisely with the support of adequate preoperative diagnostic. Extensive manipulation that could increase surgical technique difficulty or postoperative morbidity and mortality is not necessary since lipoma is a very slow-growing tumor.
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Soetisna et al. (2021) studied this question.
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