A 64-Year-Old Woman with Imaging Features Consistent with a Posterior Intrapericardial Lipoma and 5-Year Imaging Follow-Up

Patient: Female, 64-year-old Final Diagnosis: Intrapericardial lipoma Symptoms: No symptoms Medication:— Clinical Procedure: — Specialty: Cardiology OBJECTIVE: Rare disease BACKGROUND: Primary cardiac and pericardial neoplasms are rare and may be found incidentally on echocardiography. We present a case of a 5-year imaging follow-up in a patient with a large posterior pericardial lipoma diagnosed by magnetic resonance imaging of the mediastinum. CASE REPORT: A 64-year-old woman was admitted to the Department of Cardiology for detailed assessment due to an intrapericardial mass revealed on transthoracic echocardiography in an outpatient setting. Computed tomography revealed a capsulated posterior intrapericardial homogenous mass of fat density. There was no enhancement of the lesion with contrast agent administration. Ultimately, magnetic resonance imaging confirmed the benign nature of the tumor, leading to the intrapericardial mass being classified as a lipoma. Due to the clinical features of the lesion – the preserved intracardiac flow and the asymptomatic course of the disease – conservative treatment was appropriate for this patient. A 5-year imaging follow-up was uneventful, the patient remained asymptomatic, a mild tumor growth was identified by computed tomography, and there was still no recommendation for surgery. CONCLUSIONS: This case has shown that although echocardiography and computed tomography imaging can identify posterior intrapericardial tumors, magnetic resonance imaging can identify diagnostic features and support the benign nature of a tumor that may not be amenable to surgical removal.