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Updated: Nov 1, 2025

Author Spotlight: Advancements in Intracardiac Echocardiography for Atrial Anatomy Assessment
Published on: June 30, 2023
Lipoma across the wall of the right atrium
1Department of Cardiovascular Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Insights
A rare case of cardiac lipoma, a benign fatty tumor, was successfully removed from a patient's right atrium and pericardium. Surgical resection via minithoracotomy ensured complete tumor removal and a full recovery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Pathology
Background:
- Incidental diagnosis of a right atrial mass in a 44-year-old male.
- Routine examination revealed an asymptomatic cardiac anomaly.
Observation:
- Echocardiography identified a 46x30mm well-delimited, nonmobile mass in the right atrium.
- Cardiac CT showed an invasive extracardiac mass in the pericardial cavity, contiguous with the intracardiac mass.
Findings:
- Surgical exploration revealed both intracardiac and extracardiac adipose masses infiltrating the myocardium.
- Histopathology confirmed both masses as lipomas.
- Complete surgical resection was achieved using right anterolateral minithoracotomy and hypothermic cardiopulmonary bypass.
- Right atrial reconstruction was performed with a bovine pericardium graft.
Implications:
- Complete resection of cardiac lipomas, even those with extracardiac extension, is feasible and curative.
- Minimally invasive surgical techniques can be employed for complex cardiac tumor removal.
- Successful management leads to favorable patient outcomes with normal cardiac function post-operatively.
Abstract:
A 44-year-old male patient was referred to our department with unremarkable physical examination and laboratory data due to a mass which was incidentally found in the right atrial during a routine examination. Transthoracic and transesophageal echocardiography revealed a 46 × 30 mm, well-delimited, nonmobile mass in the superior portion of the right atrium. Besides the intracardiac mass, another low density was detected in adjacent pericardial cavity at cardiac computed tomography; he extracardiac mass appeared to be caused by invasive growth from the intracardiac mass. An operation was performed through right anterolateral minithoracotomy with the patient under hypothermic cardiopulmonary bypass. During operation, it was found that the surface of the right atrium was covered by an adipose mass (30 × 40 mm; Figure 2A). Intracardiac mass also showed yellow adipose tissue (40 × 50 mm; Figure 2B). Both parts of the mass infiltrated the myocardium. The mass was resected completely; and right atrium was reconstructed by using bovine pericardium pad. After the operation, the pathology confirmed the both intracardiac and extracardiac tissues as lipoma; transthoracic echocardiogram showed the atrial mass was removed completely and the left ventricular ejection fraction was normal. The patient's postoperative course was uneventful and he was discharged home after 7 days.
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