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Eur J Cardiothorac Surg 2008;33:927. doi:10.1016/j.ejcts.2008.02.023
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Images in cardio-thoracic surgery

Unusual cause for massive cardiomegaly

Christelle Ackermann*, Hendrik Willem Jacobus van Wyk, Motona Katengua, Anton Frans Doubell

Department of Radiology, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa

Received 24 October 2007; received in revised form 11 February 2008; accepted 12 February 2008.

* Corresponding author. Address: 27 Kanonnier Crescent, Kanonberg, Bellville 7530, South Africa. Tel.: +27 21938 5940/5922; fax: +27 21938 5903. (Email: ca{at}sun.ac.za).

Key Words: Cardiomegaly • Supraventricular tachycardia • Epicardial lipoma

A 25-year-old female presenting with a supraventricular tachycardia. Chest radiograph revealed cardiomegaly (Fig. 1 ). Contrast enhanced CT demonstrated a large epicardial mass, originating from the left atrioventricular groove, (Hounsfield units equal to fat) containing blind ending vessels (Fig. 2 a). Completely excised, the mass weighed 2.5 kg. Histology confirmed an epicardial lipoma (Fig. 2b and c).


Figure 1
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  		Fig. 1. Chest radiograph demonstrates massive transverse cardiomegaly with a normal aortic arch.

 

Figure 2
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  		Fig. 2. (a and b) Contrast enhanced axial CT chest reveals a large epicardial mass with blind ending vessels and Hounsfield units equal to fat. There is a normal transverse cardiac index, with the arrows indicating the large diameter of the lipoma. (Insert) Micrograph with hematoxylin and eosin stain (H&E) x200 demonstrates blood vessels embedded in mature fat. There are no special features to this lipoma. (c) Intraoperative photo with the large epicardial mass as seen through a combined sternotomy/left anterior thoracotomy approach.

 





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Right arrow Articles by Doubell, A. F.
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Right arrow Mediastinum
Right arrow Cardiac - other

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