Primary cardiac lipoma: a clinicopathological analysis

This study aims to examine the clinicopathological features of three rare cases of cardiac lipoma. This retrospective case analysis utilized a search of the institutional pathology database. Predefined inclusion criteria (pathologically confirmed primary cardiac lipoma with complete clinicopathological data) and exclusion criteria (non-neoplastic fatty lesions, other cardiac tumors, or incomplete data) were applied. Three eligible cases of primary cardiac lipoma were identified. Clinical presentations, imaging findings, pathological diagnoses, treatments, and outcomes were summarized alongside a literature review. The three patients included two males and one female, aged 44 to 75 years (mean, 57 years). Tumor diameters ranged from 2 to 4.5 cm (mean, 3 cm), all located in the right atrium. Cardiac ultrasound consistently showed well-defined, isoechoic masses. Gross examination revealed soft, yellowish, fatty nodules with a surrounding capsule. Pathological diagnosis confirmed lipoma. During follow-up (2 to 6 years), no recurrence was noted. Primary cardiac lipoma typically affects middle-aged and elderly males, exhibits slow growth, and carries a favorable prognosis with rare recurrence following complete excision. This study, presenting three pathologically confirmed cases with long-term follow-up, alongside a literature review, aims to improve understanding of this rare condition and reduce both misdiagnosis and overdiagnosis.