Image Description
Introduction: Cardiac lipomas are rare and make up <0.5% of all cardiac tumors. They originate in the epicardium (more commonly) or endocardium and can arise anywhere in the heart with a predilection for left ventricle, right atrium and atrial septum. Rare intramyocardial lipomas have been reported. Another rare location is cardiac valves. Most cardiac lipomas are solitary. Multiple lesions have been described in tuberous sclerosis.
This is an image of a resected atrial lipoma.
Image courtesy of: Dr. Ibrahim Zardawi; used with permission.
About the Disease
Primary cardiac tumors are extremely uncommon. Secondary tumors (metastases to heart) are 20-50 times more common than primary cardiac tumors and yet still relatively rare. Of primary cardiac tumors, almost 75% are benign and the remaining 25% are malignant.Benign Primary Cardiac Tumors: Myxoma (50-70% of cases), rhabdomyoma, lipoma and lipomatous hypertrophy of interatrial septum, papillary fibroelastoma, and fibroma. Angiomas and teratomas are found mainly in children. Malignant Primary Cardiac Tumors: Mostly sarcomas, including angiosarcoma (30%), rhabdomyosarcoma (20%), leiomyosarcoma, liposarcoma, osteosarcoma, fibrosarcoma, and undifferentiated pleomorphic sarcoma. Other tumors include mesothelioma and lymphoma.Secondary cardiac tumors are far more frequent than primary cardiac tumors. The most common primary sites include melanoma, lung, breast, kidney, and lymphomas. Pericardium is usually affected, resulting in pericardial effusion.Cardiac tumors may be asymptomatic and found incidentally or present with obstructive, embolic, arrhythmic or systemic symptoms, depending upon the size and location of the mass. References: 1. Miller, D. V. & Revelo M. P. (2023). Diagnostic Pathology - Cardiovascular. 3rd Edition, Elsevier.2. Sheppard, M. N. (2022). Practical Cardiovascular Pathology 3rd Edition, CRC Press.3. Maximilian B. & Butany J. (2022). Cardiovascular Pathology 5th Edition, Academic Press.