Asian Cardiovasc Thorac Ann 2004;12:278-279
© 2004 Asia Publishing EXchange Ltd
IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY |
Asymptomatic Cardiac Lipoma as a Finding In a Left Thoracotomy for Lung Cancer
Christophoros Kotoulas, MD,
Christophoros Foroulis, MD1,
Achilles Lioulias, MD1
Department of Thoracic Surgery, 401 General Military Hospital
1 Second Department of General Thoracic Surgery, Chest Diseases Hospital, Athens, Greece
For reprint information contact: Christophoros S. Kotoulas, MD Tel & Fax: 30 210 608 1367 Email: chrkotoulas{at}hol.gr 70c Bakoyanni str, Vrilissia, GR-152 35 Athens, Greece.
We present the case of a 70-year-old male with coexistence of a squamous-cell lung cancer and an asymptomatic lipoma of the cardiac wall.
Computed tomography of the chest showed an atelectasis of the left lower lobe due to a central space-occupying lesion, also a small retrosternal goiter, and without pathologic findings from the other organs of the mediastinum, except for a smooth, non-enhancing, well-marginated, fat-containing lesion (Figure 1
).
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Figure 1. CT-scan showing atelectasis of the left lower lobe and a smooth, non-enhancing, well-marginated, fat-containing, mediastinal lesion, in close contact with the heart and the inferior pulmonary vein.
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From the patient’s medical history, papillomas of the bladder and multinodular goiter were mentioned. The preoperative cardiologic examination was without pathologic findings.
The patient underwent a left pneumonectomy, through a posterolateral thoracotomy with intrapericardial ligation of the pulmonary vessels due to pericardial invasion. After performing the pericardium incision, a yellowish mass was discovered at the left atrium, which was originally considered suspicious of being a metastatic localization due to the fact that it compressed the lower pulmonary vein; however upon palpation the texture of the mass was soft, smooth and encapsulated. (Figure 2)
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Figure 2. A pneumonectomy has been performed. The pericardium has been opened and the pulmonary vessels have been ligated intrapericardially. The lipoma is held by forceps, being in close contact with the inferior pulmonary vein.
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Postoperatively, the patient presented an episode of supraventricular dysrythmia that was treated with medication. The pTNM stage was T3N1M0 and the mass corresponded to a lipoma. (Figure 3)
