Bajdechi Mircea, Onciul Sebastian, Costache Victor, Brici Sergiu, Gurghean Adriana
First Department, Medical Semiology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest 050474, Romania.
Department of Cardiology, 'Coltea' Clinical Hospital, Bucharest 900711, Romania.
Exp Ther Med. 2022 Sep 28;24(5):697. doi: 10.3892/etm.2022.11633. eCollection 2022 Nov.
Cardiac lipomas are generally asymptomatic even in large dimensions. Echocardiograms can identify tumors, but cardiac magnetic resonance imaging or cardiac computerized tomography can differentiate cardiac lipomas from other cardiac tumors. The present study is a case report of an asymptomatic 30-year-old man diagnosed with atrial lipoma. The patient received cardiac surgery and the intervention consisted of exclusion of the right atrial (RA) tumor and reconstruction of the right atrium with 'XenoSure' patch in extracorporeal circulation through a minimally invasive approach. A short PubMed literature review was performed and 26 cases of RA lipomas with available details were found. Cardiac tumors may cause clinical presentation through different pathways. Symptoms related to an RA lipoma were present in 21 out of 26 patients (80%). The symptoms varied greatly, dyspnea being the most common of them. In one case, the lipoma was found during the autopsy of a patient after sudden death. Large cardiac lipomas can lead to complications such as obstruction of ventricular outflow tract, electric disorders, embolism or pericardial effusion. Obstruction of the right ventricular outflow tract was reported in 11 out of 26 patients (42%) diagnosed with RA lipoma. Generally, atrial lipoma can have various sizes. The most useful imaging technique was transthoracic echocardiography. Accurate diagnosis and evaluation of cardiac lipoma is dependent on multimodality imaging methods, including cardiac magnetic resonance. Surgery is the treatment of choice, but the risk-benefit ratio must be considered, and shared decision making must be taken into account. The present review data showed that 23 out of 25 patients (92%) underwent surgery. Among these patients, only 1 out of 23 received a minimally invasive approach in 2021. Cardiac lipomas are rare entities, usually asymptomatic, that can occur at any age. The most useful diagnostic method of cardiac tumors is echocardiography, but nuclear magnetic resonance can also specify the type and characteristics of tumors.
心脏脂肪瘤通常即使体积很大也无症状。超声心动图可识别肿瘤，但心脏磁共振成像或心脏计算机断层扫描能将心脏脂肪瘤与其他心脏肿瘤区分开来。本研究是一例30岁无症状男性被诊断为心房脂肪瘤的病例报告。患者接受了心脏手术，干预措施包括通过微创方法在体外循环下切除右心房（RA）肿瘤并用“XenoSure”补片重建右心房。进行了简短的PubMed文献综述，发现了26例有可用详细信息的RA脂肪瘤病例。心脏肿瘤可通过不同途径引起临床表现。26例患者中有21例（80%）出现了与RA脂肪瘤相关的症状。症状差异很大，其中呼吸困难最为常见。在一例中，脂肪瘤是在一名患者猝死后的尸检中发现的。大型心脏脂肪瘤可导致并发症，如心室流出道梗阻、电紊乱、栓塞或心包积液。在26例被诊断为RA脂肪瘤的患者中，有11例（42%）报告了右心室流出道梗阻。一般来说，心房脂肪瘤大小各异。最有用的成像技术是经胸超声心动图。心脏脂肪瘤的准确诊断和评估依赖于多模态成像方法，包括心脏磁共振成像。手术是首选治疗方法，但必须考虑风险效益比，并进行共同决策。目前的综述数据显示，25例患者中有23例（92%）接受了手术。在这些患者中，2021年只有23例中的1例采用了微创方法。心脏脂肪瘤是罕见的实体，通常无症状，可发生于任何年龄。心脏肿瘤最有用的诊断方法是超声心动图，但核磁共振也能明确肿瘤的类型和特征。
