Giant intrapericardial lipoma: clinical and forensic implications

Milenko Bogdanović; Snežana Pavlekić; Maja Milošević; Bojana Radnić; Jovana Lakčević; Stefan Veljković; Djordje Alempijević; Miloš D. Babić

doi:10.2298/VSP200922023B

Milenko Bogdanović University of Belgrade, Faculty of Medicine, Institute of Forensic Medicine “Milovan Milovanović”, Belgrade, Serbia
Snežana Pavlekić University of Belgrade, Faculty of Medicine, Institute of Forensic Medicine “Milovan Milovanović”, Belgrade, Serbia
Maja Milošević Institute for Cardiovascular Diseases “Dedinje”, Department of Cardiology, Belgrade, Serbia
Bojana Radnić University of Belgrade, Faculty of Medicine, Institute of Forensic Medicine “Milovan Milovanović”, Belgrade, Serbia
Jovana Lakčević Institute for Cardiovascular Diseases “Dedinje”, Department of Cardiology, Belgrade, Serbia
Stefan Veljković Institute for Cardiovascular Diseases “Dedinje”, Department of Cardiology, Belgrade, Serbia
Djordje Alempijević University of Belgrade, Faculty of Medicine, Institute of Forensic Medicine “Milovan Milovanović”, Belgrade, Serbia
Miloš D. Babić Institute for Cardiovascular Diseases “Dedinje”, Department of Cardiology, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP200922023B

Keywords: autopsy, cause of death, diagnosis, lipoma, myocardial infarction, pericardium, syncope

Abstract

Introduction. Even though lipomas are the most common benign tumors, they are rarely found in the pericardial cavity. Although histopathologically benign, they can cause life-threatening complications by rapid growth and may therefore be clinically considered malignant. Case report. We present an 80-year-old female who was injured during a syncopal episode when falling from a standing height and suffered bodily injuries for which she was hospitalized. In the further course of her short-term hospital treatment, death occurred, and the cause of death was marked as “unknown”. At the autopsy, a dilated and tense pericardium filling up a large part of the chest cavity was noted. A well-encapsulated soft tissue mass, 20 × 18 × 3 cm in size, weighing 820 g, was visualized in the pericardial cavity. Histopathological examination revealed that the mass was a lipoma and showed acute myocardial necrosis; therefore, it was assumed that the cause of death was probably due to the compression of lipoma on coronary arteries. Conclusion. Even though intrapericardial lipomas are benign tumors, they can cause life-threatening complications and sudden cardiac death. There are numerous diagnostic methods capable of detecting intrapericardial lipomas, and with timely treatment, the patient can be cured.

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