Case of the week 08-11: Right Atrial Lipoma

1. Case of the week 08-11: Right Atrial Lipoma 1 History: A 37 yr ♀ had an echocardiogram for chest pain showing a possible mass (figure 1) in the right atrium. CMR was performed to further characterise this. CMR: A well circumscribed, ovoid mass (3x3x2cm) in the right atrium along the free wall (figure 2).This area appears hyper-intense on images obtained using T1 weighted turbo SE sequences (figure 3a). However, there is signal suppression in this area, as well as abdominal adipose tissue, when fat saturation sequences are applied (figure 3b). These findings are higly suggestive of a lipoma. No invasion of the atrial wall is noted. Perspective: Cardiac MR offers excellent differentiation of suspected cardiac masses via tissue characterisation as well as their relationship to adjacent structures. A cardiac lipoma can be easily identified due to its typical T1 relaxation time and signal suppression with fat saturated sequences. There has been no further treatment of this incidental finding given that there is no arrhythmia or hemodynamic compromise. 2 3a 3b Ali Z. Merchant, John Hibbeln and Clifford J Kavinsky. Rush University Medical Center, Chicago, IL, USA. Handling editor: Mark Westwood