Key result
Multi-modality imaging correctly diagnosed lipomatous hypertrophy of the interatrial septum after initial misinterpretation on transthoracic echocardiography.
Case Report (n=1)
Multi-modality imaging and careful review of routine CT scans are crucial for accurately diagnosing benign cardiac masses like lipomatous hypertrophy of the interatrial septum and avoiding unnecessary imaging cascades.
May reduce echocardiography misdiagnosis of benign masses; leaves open prospective validation of multi-modality protocols.
INTRODUCTION: Lipomatous hypertrophy of the interatrial cardiac septum is a benign disorder. In rare cases, the disorder can cause obstruction of atrial inflow, causing symptoms of heart failure, or cardiac arrhythmias resulting from the involvement of the atrial wall and atrioventricular conduction pathways. CASE PRESENTATION: We present a case of a Caucasian 66-year-old man with urothelial carcinoma where transthoracic echocardiolography showed a mass in the basal part of the interatrial septum. After injection of echo contrast, it was suggested that the structure was vascularized, thus implying tumour. Transoesophageal echocardiography and cardiac magnetic resonance imaging gave the correct diagnosis of lipomatous hypertrophy. It was then discovered that the patient had been referred to a computed tomography (CT) earlier, but no mention of the mass was found in the report from the examination. Re-evaluation of the images showed a clearly visible mass indicative of fatty tissue. CONCLUSION: This case report highlights the importance of multi-modality imaging when the findings are not concordant. Moreover, this case report also highlights the importance of careful examination of the heart on routine CT scans, something that is often overlooked by the radiologists. In this case, the CT scan clearly indicated the diagnosis of lipomatous hypertrophy of the interatrial septum and thus could have prevented the subsequent imaging cascade.
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Trägårdh-Johansson et al. (2010) conducted a case report in Lipomatous hypertrophy of the interatrial septum (n=1). Multi-modality imaging was evaluated on Diagnosis of lipomatous hypertrophy. Multi-modality imaging correctly diagnosed lipomatous hypertrophy of the interatrial septum after initial misinterpretation on transthoracic echocardiography.
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