Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Techonolgy, No.1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
J Cardiothorac Surg. 2021 Jan 6;16(1):1. doi: 10.1186/s13019-020-01379-6.
Cardiac lipoma is an uncommon primary cardiac tumor. With the advancement of diagnostic methods and treatment techniques, more cases of cardiac lipomas have been reported and suggest that the entity previously widely thought to display classic features may also show atypical findings. A systemic review of the rare cardiac tumor was done by searching the literature of cardiac lipoma. We endeavor to summarize the clinical features of the rare disease from pathogenesis to treatment. Literature of cardiac lipoma was retrospectively searched through PubMed and 255 cases of cardiac lipoma were included into this analysis. Cardiac lipomas can occur anywhere within the heart, 53.1% were located within the cardiac chambers, 32.5% in the pericardium, 10,7% within the myocardium and 3.7% involved multiple structures. More than half of the reported cardiac lipomas (66%) may be clinically symptomatic, presenting with symptoms ranging from chest discomfort to syncope depending on their size and location as well as extent of myocardial involvement. Noninvasive cardiac imaging has replaced the role of autopsy and cardiothoracic surgery in detection and diagnosis of cardiac lipomas. Most symptomatic patients (83.7%) were treated by resection of cardiac lipomas and 68.3% of asymptomatic patients also underwentprophylactic resection. Overgrowth and myocardial infiltration of lipomas may result in unsuccessful resection. Recurrence of cardiac lipomas was rare but reported in a few cases. The early detection and accurate diagnosis of cardiac lipoma is of great significance in clinical management, to avoid an unfavourable outcome due to overgrowth.
心脏脂肪瘤是一种罕见的原发性心脏肿瘤。随着诊断方法和治疗技术的进步,越来越多的心脏脂肪瘤病例被报道,这表明以前被广泛认为具有典型特征的实体瘤也可能出现非典型表现。通过检索心脏脂肪瘤的文献,对罕见的心脏肿瘤进行了系统评价。我们努力从发病机制到治疗总结这种罕见疾病的临床特征。通过 PubMed 回顾性检索心脏脂肪瘤文献,共纳入 255 例心脏脂肪瘤病例进行分析。心脏脂肪瘤可发生在心脏的任何部位,53.1%位于心腔,32.5%位于心包,10.7%位于心肌,3.7%累及多个结构。超过一半的报道心脏脂肪瘤(66%)可能有临床症状,根据其大小和位置以及心肌受累程度,表现为从胸痛到晕厥等各种症状。非侵入性心脏成像已取代尸检和心胸外科手术在心脏脂肪瘤的检测和诊断中的作用。大多数有症状的患者(83.7%)接受心脏脂肪瘤切除术治疗,68.3%的无症状患者也接受预防性切除术治疗。脂肪瘤的过度生长和心肌浸润可能导致无法成功切除。心脏脂肪瘤的复发很少见,但有少数病例报道。早期发现和准确诊断心脏脂肪瘤对临床管理具有重要意义,可避免因过度生长而导致不良后果。