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Lipomatous hypertrophy of the interatrial septum: a commonly misdiagnosed mass often leading to unnecessary cardiac surgery
  1. I Nadra1,
  2. D Dawson1,
  3. S A Schmitz2,
  4. P P Punjabi3,
  5. P Nihoyannopoulos1
  1. 1Department of Cardiology, National Heart and Lung Institute, Imperial College, Hammersmith Hospital, London, UK
  2. 2Imaging Sciences Department, Clinical Sciences Centre, Faculty of Medicine, Imperial College
  3. 3Department of Cardiothoracic Surgery, National Heart and Lung Institute, Imperial College
  1. Correspondence to:
    Dr I Nadra
    Department of Cardiology, National Heart and Lung Institute, Imperial College, Hammersmith Hospital, Du Cane Road, London W12 0HS, UK; i.nadraimperial.ac.uk

Abstract

Lipomatous hypertrophy of the interatrial septum is a benign cardiac mass that should be considered as part of the differential diagnosis for any atrial cardiac tumour. In the reported case, this lesion was initially suspected to be malignant and the patient was thus referred directly to cardiac surgeons for surgical removal. Unnecessary surgical intervention was swiftly averted because the cardiac surgeon promptly referred the patient for an expert echocardiogram that confirmed the diagnosis of lipomatous hypertrophy. The authors discuss the characteristic features of this lesion and how the diagnosis may be made based on several non-invasive imaging modalities without the need for a tissue biopsy. This condition is more common than initially thought and remains under-recognised by most clinicians. In such cases an increased awareness of this lesion along with the opinion of a specialist echocardiologist would help to avoid a misdiagnosis and unnecessary intervention.

  • CT, computed tomography
  • MRI, magnetic resonance imaging
  • TOE, transoesophageal echocardiography
  • lipomatous hypertrophy
  • interatrial septum
  • cardiac mass and cardiac surgery

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Footnotes

  • Funding: none.

  • Conflict of interest: none.

  • I Nadra wrote the report. D Dawson and SA Schmitz carried out the imaging of the patient. PP Punjabi and P Nihoyannopoulos were involved in managing the patient.

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