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Intravascular Lipiodol Presenting as an Atrial Mass
Ruud S Kootte1, Joost D E Haeck1, Krijn P van Lienden2
1Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
The Annals of Thoracic Surgery
|February 22, 2017
Summary
A rare Lipiodol-induced thrombus, a complication of thoracic duct embolization, presented as a mass in the inferior vena cava and right atrium. This is the first clinicopathologic report of such an intracavitary mass.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Pathology
Background:
- Thoracic duct embolization is a procedure used to treat lymphatic leaks.
- Lipiodol (an ethiodized oil) and cyanoacrylate glue are commonly used embolic agents.
- Complications, though rare, can occur following such interventions.
Observation:
- A 68-year-old woman presented with an asymptomatic mass in the inferior vena cava (IVC) and right atrium.
- The patient had a history of thoracic duct embolization using Lipiodol and cyanoacrylate glue.
- The mass was discovered incidentally during medical evaluation.
Findings:
- Surgical removal of the intracavitary mass was performed.
- Pathologic analysis confirmed the mass to be a thrombus.
- The thrombus contained Lipiodol, indicating a Lipiodol-induced etiology.
Implications:
- This case highlights a novel complication of thoracic duct embolization with Lipiodol.
- Lipiodol-induced thrombus formation should be considered in patients with a history of embolization presenting with intracavitary masses.
- Further research may be warranted to understand the mechanism and incidence of this rare complication.
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