case_images: PMC4998283_01
case_images: Echocardiographic findings show a large mass involving the IVS (A) and the RV wall (B) lining toward the RV cavity. The subxiphoid 4-chamber view displays the mass adherent to the IVS (white arrow) and the RV wall (black arrow; C). Schematic diagram of the subxiphoid 4-chamber view (D). IVS = interventricular septum; RV = right ventricle.
case_images: medi-95-e2561-g001.jpg
case_images: PMC4998283_01_medi-95-e2561-g001.jpg
case_images: F1
case_images: 2D-TTE (Philips IE33; Philips Healthcare, Eindhoven, Netherlands) demonstrated an irregular hyperechoic mass adherent to the IVS with a broad base (Figure 1A). Incidentally, another echogenic mass measuring 4.6 x 1.5 cm was observed to be adherent to the RV wall (Figure 1B); it was irregular and showed good mobility. In the subxiphoid 4-chamber view, the mass was adherent to the IVS and the RV wall (Figure 1C and D).
case_images: Contrast enhancement ultrasound findings show few contrast agent enhancements in the tumor structure (white arrow; A); real-time 3D full-volume bird's eye view findings of the mass adherent to the IVS and attached to the RV wall (B). IVS = interventricular septum; MV = bicuspid valve; RV = right ventricle.
case_images: medi-95-e2561-g002.jpg
case_images: PMC4998283_01_medi-95-e2561-g002.jpg
case_images: F2
case_images: CEUS demonstrated that there was a slight enhancement of the contrast agent inside the mass (Figure 2A). However, subsequent RT-3DE showed the involved scope of the mass was nearly attached to the right ventricular apex (Figure 2B).
case_images: An echogenic RV mass is seen on transthoracic echocardiography. The horizontal, long-axis (4-chamber view), T1-weighted, black-blood image showing a well-circumscribed, high-signal mass in the RV cavity (arrow, A). The horizontal, long-axis, T1-weighted black-blood image showing the mass adherent to IVS (arrow, B). IVS = interventricular septum; LA = left atrium; LV = left ventricle; RA = right atrium; RV = right ventricle.
case_images: medi-95-e2561-g003.jpg
case_images: PMC4998283_01_medi-95-e2561-g003.jpg
case_images: F3
case_images: Images revealed a homogeneous high-signal intensity within a quite irregular mass, which was adherent to the RV side of the IVS with a broad base that measured approximately 4.0 x 1.6 cm in maximal transverse diameter (Figure 3).
case_images: Surgical and pathology findings show a yellowish tumor involving the chordae of tricuspid valve (arrow, A); the tumor is suspended by sutures (arrow, B). After resection of the tumor, a pile of tissue in the water (C); stained with hematoxylin and eosin (H&E) at 100 magnification: the tumor comprised mature adipocytes with entrapped myocardial cells (D). H&E = hematoxylin and eosin.
case_images: medi-95-e2561-g004.jpg
case_images: PMC4998283_01_medi-95-e2561-g004.jpg
case_images: F4
case_images: The tumor was removed in pieces, with part of the IVS and the tricuspid valve chordae (Figure 4A and B). The gross appearance of the surgically resected tumor was a pile of yellowish pieces of smooth tissue (Figure 4C). Histological examination of the surgical specimen was used to determine the diagnosis of infiltrating lipoma of the RV (Figure 4D).