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Archives of cardiovascular diseases
Volume 107, n° 5
pages 343-344 (mai 2014)
Doi : 10.1016/j.acvd.2012.05.013
Received : 2 April 2012 ;  accepted : 22 May 2012
Voluminous pseudotumoral lipomatous hypertrophy of the interatrial septum
Volumineuse hypertrophie pseudotumorale du septum interatrial
 

Yann Ancedy a, Christophe Thuaire a, , Jérôme Garot b
a Service de cardiologie, centre hospitalier Louis-Pasteur, BP 407, 28018 Chartres cedex, France 
b IRM cardiovasculaire, institut hospitalier Jacques-Cartier, 6, avenue du Noyer-Lambert, 91300 Massy, France 

Corresponding author.

Keywords : Lipomatous hypertrophy, Interatrial septum, Cardiovascular magnetic resonance, Transoesophageal echocardiography

Mots clés : Lipome hypertrophique, Septum inter-auriculaire, Imagerie par résonance magnétique cardiaque, Échographie transœsophagienne


A 60-year-old asymptomatic man was referred for assessment of an intracardiac mass. He had a history of bladder cancer and surgery for subcutaneous lipoma. Computed tomography of the chest performed to evaluate bladder neoplasia extension showed a right atrial mass (6.8×3.4cm; Figure 1.1). Transoesophageal echocardiogram demonstrated a non-protruding intracardiac mass (5×5cm; Figure 1.2) localized within the interatrial septum but without extension to the foramen ovale. There was no sign of right atrial inflow obstruction. The workup was completed with cardiovascular magnetic resonance (CMR), which confirmed the diagnosis of typical lipomatous hypertrophy of the interatrial septum (LHSIA) showing a spontaneous hyper signal on T1- and T2-weighted black-blood spin echo images and no contrast enhancement after gadolinium injection (Figure 1.3 and 1.4). The thickened tissue was extended to the posterior wall of the right atrium with a non-significant compression of the superior vena cava. Our heart team rejected the idea of surgery in this asymptomatic patient with an uncomplicated mass.



Figure 1


Figure 1. 

1. Computed tomography scan of the chest. 2. Transesophageal echocardiography transverse view 120°. 3. CMR image: SSFP sequence in the coronal view. 4. CMR image: black-blood T1-weighted spin echo in the transverse view. Ao: aorta; L: lipoma; LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle.

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LHSIA is a benign process, with specific CMR patterns that confirm diagnosis without histological evidence. This entity is well described but under-recognized. Usually incidentally discovered, LHSIA has no specific treatment.

Disclosure of interest

The authors declare that they have no conflicts of interest concerning this article.


Appendix A. Supplementary data

(1.46 Mo)
  


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