Key result
Multimodal imaging and surgical histologic examination successfully diagnosed a rare giant pericardial lipoma in a 48-year-old woman presenting with severe intestinal bleeding.
Why the study?
Large circumferential tumors encasing the heart are exceedingly rare, with a broad differential diagnosis that exceptionally includes mature benign lipoma.
Case Report (n=1)
Multimodal imaging is essential for the differential diagnosis of rare, incidentally found giant pericardial masses such as benign lipomas.
Benign lipoma should enter the differential for encasing pericardial masses; leaves open optimal noninvasive diagnosis pending larger series.
Large circumferential tumors encasing the heart are exceedingly rare, and the differential diagnosis include primary pericardial sarcomas, non-Hodgkin lymphoma, pericardial primitive neuroectodermal tumor, primary pericardial mesothelioma, and exceptionally mature benign lipoma. Lipomas are rare primary heart tumors. Most are epicardial in origin, although they may arise in the myocardium. They are usually soft masses of mature fat tissue encapsulated by a thin layer of fibrous tissue. Signs and symptoms depend on the tumor's location and size, however in several case they are found incidentally at cardiac imaging. In this 48-year-old woman referred to the emergency department for severe intestinal bleeding, echocardiography showed a large circumferential hypoechogenic space, and CT confirmed a large mediastinal fat mass encasing the heart. Multimodal imaging allowed differential diagnosis confirmed by histologic examination performed at surgery.
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Campana et al. (2025) conducted a case report in Giant Pericardial Lipoma (n=1). Multimodal imaging and surgery was evaluated on Diagnosis of pericardial lipoma. Multimodal imaging and surgical histologic examination successfully diagnosed a rare giant pericardial lipoma in a 48-year-old woman presenting with severe intestinal bleeding.
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