J Cardiovasc Ultrasound.  2014 Sep;22(3):151-154. 10.4250/jcu.2014.22.3.151.

Malignant Arrhythmia with Benign Tumour: Fibrolipoma of the Left Ventricle

• Sajeev CG
• Kalathingathodika S
• Nair A
• Muneer K
• Rajesh GN
• Deshabandhu V
• Subramaniam G
• Pillai RS
• Kuriakose
• Krishnan M

• KMID: 2045433
• DOI: http://doi.org/10.4250/jcu.2014.22.3.151

Abstract

We report a case of young male referred for evaluation of recent onset recurrent syncope. Inhospital electrocardiogram revealed an episode of ventricular flutter which reverted spontaneously to sinus rhythm. Transthoracic echocardiogram showed hyperechoic mass in the left ventricle. For further tissue characterization a cardiac magnetic resonance imaging was done which revealed a left ventricular mass with predominant fat content. The tumor was surgically resected. Histopathological examination confirmed the diagnosis of cardiac fibrolipoma. The patient recovered and is currently asymptomatic.

Keyword

Fibrolipoma; Ventricular flutter; Syncope; Cardiac tumor; Cardiac magnetic resonance

MeSH Terms

Arrhythmias, Cardiac*
Diagnosis
Electrocardiography
Heart Neoplasms
Heart Ventricles*
Humans
Magnetic Resonance Imaging
Male
Syncope
Ventricular Flutter

Figure

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  Fig. 1 A: Electrocardiogram rhythm strip showing ventricular flutter with spontaneous termination. Transthoracic echocardiogram showing hyper-echoic mass in left ventricular cavity arising form posterior wall (B: parasternal long axis view, C: parasternal short axis view, D: apical 4 chamber view). AO: aorta, LA: left atrium, LV: left ventricle.

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  Fig. 2 Cardiac magnetic resonance imaging of left ventricular mass. A: T1-weighted image showing lobulated hyperintense lesion with peripheral hypointensity on saggital view. B: T1-weighted image-axial view. C: Double inversion recovery image showing hyperintense lesion indicating fat. D: Tripple inversion recovery image showing fat suppression. E: Complete suppression in signal intensity of fat on short tau inversion recovery sequence. F: Image showing post gadolinium delayed hypointense signal intensity in cardiac mass lesion suggestive of fibrous tissue.

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  Fig. 3 A: Surgical picture showing the open left ventricle and the tumour being dissected. B: Gross specimen of the tumor. C: Histopathology showing mature fat cells with occasional fibrous connective tissue consistent with fibrolipoma (H&E stain, × 100 magnification). Post operative transthoracic echocardiogram showing complete clearance of left ventricular tumor (D: apical four chamber view, E: short axis view, F: parasternal long axis view).

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