Fibrolipoma of the left ventricle: an uncommon incidental autopsy finding

Fibrolipoma of the heart is an unusual benign tumorous entity encountered, if present, during an ordinary imaging workout or at autopsy. It is often clinically silent but it can also be symptomatic depending on the size and location of the tumor. We report a case of an 82-year-old man with a medical history of malignant pleural mesothelioma. The decedent was referred to our department to undergo a forensic autopsy after a fall. Postmortem examination revealed a large encapsulated gelatinous, yellowish cardiac mass with its pedicle on the subendocardial region of the left ventricular anterior wall and interventricular septum, protruding into the left ventricular cavity. Histological examination confirmed the diagnosis of cardiac fibro-lipoma, a rare histologic variant of lipoma, irrelevant to the cause of death in the present case. The rarity of the occurrence of fibro-lipomas provides clinical implications for the inclusion of the entity in the differential diagnosis of a cardiac mass.