Abstract
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.
Similar content being viewed by others
References
Maraj S, Pressman GS, Figueredo VM. Primary cardiac tumors. Int J Cardiol. 2009;133:152–6.
Wilson S, Frederick J, Braunwald E. Primary tumors of the heart. In: Braunwald E, editor. Heart disease. A textbook of cardiovascular medicine. 5th ed. Philadelphia: Saunders; 1997. p. 1464–77.
Fine G. Neoplasms of the pericardium and heart. In: Gould SE III, editor. Pathology of the heart and blood vessels. Springfield: Charles C. Thomas; 1968. pp. 865.
Akram K, Hill C, Neelagaru N, Parker M. A left ventricular lipoma presenting as heart failure in a septuagenarian: a first case report. Int J Cardiol. 2007;114:386–7.
Cunningham KS, Veinot JP, Feindel CM, Butany J. Fatty lesions of the atria and interatrial septum. Hum Pathol. 2006;37:1245–51.
Fieno DS, Saouaf R, Thomson LE, Abidov A, Friedman JD, Berman DS. Cardiovascular magnetic resonance of primary tumors of the heart: a review. J Cardiovasc Magn Reson. 2006;8:839–53.
Lamba G, Frishman WH. Cardiac and pericardial tumors. Cardiol Rev. 2012;20:237–52.
Bielicki G, Lukaszewski M, Kosiorowska K, Jakubaszko J, Nowicki R, Jasinski M. Lipomatous hypertrophy of the atrial septum - a benign heart anomaly causing unexpected surgical problems: a case report. BMC Cardiovasc Disord. 2018;18:152.
Hejna P, Janík M. Lipomatous hypertrophy of the interatrial septum: a possibly neglected cause of sudden cardiac death. Forensic Sci Med Pathol. 2014;10:119–21.
Kimura F, Matsuo Y, Nakajima T, Nishikawa T, Kawamura S, Sannohe S, et al. Myocardial fat at cardiac imaging: how can we differentiate pathologic from physiologic fatty infiltration? Radiographics. 2010;30:1587–602.
Bancroft LW, Kransdorf MJ, Peterson JJ, O'Connor MI. Benign fatty tumors: classification, clinical course, imaging appearance, and treatment. Skelet Radiol. 2006;35:719–33.
Sajeev CG, Kalathingathodika S, Nair A, et al. Malignant arrhythmia with benign tumour: fibrolipoma of the left ventricle. J Cardiovasc Ultrasound. 2014;22:151–4.
Epivatianos A, Markopoulos AK, Papanayotou P. Benign tumors of adipose tissue of the oral cavity: a clinicopathologic study of 13 cases. J Oral Maxillofac Surg. 2000;58:1113–7.
Italiano A, Ebran N, Attias R, Chevallier A, Monticelli I, Mainguené C, et al. NFIB rearrangement in superficial, retroperitoneal, and colonic lipomas with aberrations involving chromosome band 9p22. Genes Chromosome Canc. 2008;47:971–7.
Araoz PA, Mulvagh SL, Tazelaar HD, et al. CT and MR imaging of benign primary cardiac neoplasms with echocardiographic correlation. Radiographics. 2000;20:1303–19.
Constantine G, Shan K, Flamm SD, et al. Role of MRI in clinical cardiology. Lancet. 2004;363:2162–71.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Fragkouli, K., Mitselou, A. & Vougiouklakis, T. Fibrolipoma of the left ventricle: an uncommon incidental autopsy finding. Forensic Sci Med Pathol 16, 362–365 (2020). https://doi.org/10.1007/s12024-019-00197-0
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12024-019-00197-0