Mediastinal Lipoma: An Unusual Cause of Progressive Dyspnea

Mediastinal lipomas, while rare, can present with progressive dyspnea.

Our case describes a 62-year-old woman presenting with slowly progressive exertional dyspnea over the course of 2 years with a largely unremarkable initial cardiac and pulmonary evaluation. Advanced imaging ultimately revealed a large mediastinal lipoma causing a compressive effect on her left atrium and pulmonary veins.

This case highlights the importance of considering structural lesions within the mediastinum in the differential diagnosis of exertional dyspnea, particularly when conventional cardiac and pulmonary evaluations fail to elucidate the underlying etiology.

Structural lesions, such as slow-growing mediastinal tumors, can cause long-standing progressive exertional dyspnea through mechanical compression of vital structures in the thoracic cavity. Once symptomatic, surgical resection results in symptomatic relief and is curative.