Extensive cardiac lipoma with aneurysmal right ventricle

Abstract

A 56-year-old female with history of mitral valve replacement and automated implantable cardioverter-defibrillator placement presented with dyspnea on exertion for two years and recurrent ascites. Imaging studies, including transthoracic and transesophageal echocardiograms as well as 64-slice computed tomography (CT) angiogram revealed a large mass encasing the entire heart consistent with lipoma. In addition, a right ventricular free wall aneurysm was found. The patient subsequently underwent surgical repair of the tricuspid valve and resection of the right ventricular anterior wall aneurysm. The anterior portion of the cardiac lipoma was also resected. Gross specimen revealed an 11.5×6.5×5 cm mass of adipose tissue without malignancy. In this case, the patient presented with symptoms of congestive heart failure due to the aneurysm in the right ventricle.